Question
The newborn developed jaundice on the second day after birth. Blood tests revealed a bilirubin level of 340. After 3 days of hospital treatment, the jaundice decreased. However, in the past two days, the bilirubin levels have fluctuated. The level dropped to 220 the day before, but rose to 250 in the morning yesterday. After treatment, it dropped to 202 yesterday, but rose again to over 260 this morning. Is it normal for the condition to fluctuate like this? At what level does the jaundice need to drop to be considered cured? How many days of observation are required after recovery before discharge? Will there be a recurrence after discharge?
Answer
Neonatal jaundice can be either physiological or pathological. Physiological jaundice usually appears 2-3 days after birth, gradually deepening, reaching its peak between the 4th and 6th day, and then gradually diminishing. Full-term infants generally see it disappear within 2 weeks after birth, while premature infants take about 3 weeks. Pathological jaundice has characteristics such as early onset of jaundice, delayed regression time, severe levels of jaundice, and associated abnormalities. Severe pathological jaundice can lead to kernicterus, causing damage to the nervous system and even death. Therefore, when a child develops jaundice, parents should closely monitor the situation and seek medical assistance promptly if the level of jaundice is severe or accompanied by other abnormalities. In addition, providing the newborn with adequate hydration, observing the color of stool, and expelling meconium early all help in the resolution of jaundice.