In newborn babies, high levels of bilirubin in the blood for some reasons cause jaundice. This condition, which can pass in 1-2 weeks with the necessary treatments, can last up to 12 weeks if not treated correctly or not recognized. This condition that worries parents is called prolonged jaundice. But is this situation dangerous? The answers are in our article.
What is Jaundice?
Jaundice becomes noticeable when the jaundice level in the blood exceeds 2 mg/dl in adults and 6 mg/dl in newborn babies. A certain proportion of newborn babies get jaundice.
What is prolonged jaundice?
For babies born on time, 15. day; and in preterm babies (37 weeks of gestation and before) on day 21. Hyperbilirubinemia with a serum total bilirubin value above 10 mg/dl per day is considered to be prolonged jaundice.
Prolonged Jaundice in the Newborn
Bilirubin elevation may be direct or indirect. Jaundice is prolonged in 15-40% of breastfed babies. Breast milk is the most important cause of prolonged jaundice. Other possible factors should be evaluated to determine this cause. For prolonged jaundice, tests that measure elevated direct bilirubin levels are very important for diagnosis and treatment.
Direct Jaundice Can Cause Liver Failure
Prolonged direct bilirubin elevation in infants is caused by liver-related causes such as hepatitis and biliary atresia; white colored and pasty stools, tea-colored urine, enlarged spleen and liver, fluid accumulation in the abdomen, edema, variceal bleeding and finally brain involvement.
The only treatment for end-stage liver failure is liver transplantation, although it can be supported with medication in the early stages. The most common reason for liver transplantation in infants is jaundice due to underdevelopment of the biliary tract. In the early days, babies look healthy except for jaundice and white, pasty stools. Without early diagnosis and surgical intervention, cirrhosis due to bile accumulation develops within a year at the latest and leads to liver failure.
Causes of prolonged jaundice
- Breast milk jaundice
- Hemolytic diseases
- Hypothyroidism
- Crigler Najjar syndrome
- Pyloric stenosis
- Accumulation of blood outside the vessel
- Diseases related to bile accumulation
- Hepatitis of unknown cause and conditions mimicking these complaints
- Viral hepatitis and different causes related to infection
- Metabolic diseases
- Toxic and drug-related factors
What is breast milk jaundice?
The most common cause of prolonged jaundice is breast milk. Late breast milk jaundice starts in the first week after birth and peaks in the second week. When does prolonged jaundice go away? The answer to the question is that jaundice disappears in 2-3 weeks or 12-13 weeks depending on its severity.
Symptoms of Prolonged Jaundice
- Yellowing of the whole body, first of the face, then progressing to the feet,
- Your baby’s skin turns yellow on contact,
- Symptoms of breast milk jaundice include weakness, sleepiness and the baby’s inability to open its eyes.
When consulting a doctor with these symptoms, the doctor will determine the cause of the jaundice in the baby, the stage it is in and how it progresses.
How does prolonged jaundice go away?
How does prolonged jaundice in infants go away? The question is a frequently wondered topic. To treat prolonged jaundice, the cause must first be found. Often it is not possible to determine this. The first step in the differentiation of jaundice is to determine whether the disease is direct or indirect. If there are no symptoms suggestive of any causative agent during the examination, some tests are recommended.
Stage 1 tests
- Serum Total and direct bilirubin, serum
- Blood type
- Complete blood count
- Complete urinalysis and urine culture
- Thyroid function tests
- Reducing substance detection in urine
Stage 2 tests
- Liver function tests
- Sweat test
- Amino acid levels in urine and blood
Treatment should be based on the outcome. If no cause can be identified, the cause of prolonged jaundice should be considered to be breast milk.