ConsequencesLate consequences
A physiological, harmless newborn icterus of light to medium intensity usually heals on its own without any consequences. Therefore, there are no (late) consequences. However, if the bilirubin concentration in the blood exceeds a certain threshold value (Icterus gravis = more than 20 mg/dl), there is a risk that the bilirubin will “cross over” into the brain and thus lead to a nuclear icterus with the death of nerve cells.
Preferably, this leads to cell destruction in the so-called basal ganglia. These are brain structures that are of great importance for the regulation of movement, information and emotion processing. If a newborn child suffers from a cernicterus, an adequate therapy must be initiated as soon as possible (usually already from bilirubin concentrations of >15mg/dl) in order to prevent irreversible brain damage. Otherwise, serious late effects for the child may occur, characterized by mental and motor development delays, epileptic seizures, movement disorders (spasticity in the context of infantile cerebral palsy) and deafness.
Is neonatal jaundice contagious?
The causes of physiological neonatal jaundice are not due to infections. There is therefore no risk of infection. Pathological neonatal jaundice can be caused by infectious hepatitis in rare cases. Infection is then potentially possible depending on the type of hepatitis.
Therapy
Since the physiological neonatal jaundice usually heals on its own after one to one and a half weeks without any consequences, no therapy is actually necessary. However, if the bilirubin concentration in the blood of the newborn increases too high, a suitable therapy is primarily carried out to prevent the dreaded complication of a nuclear icterus. The two most common therapy options are phototherapy and so-called exchange transfusion.
In phototherapy, artificial light in the blue range (430-490nm wavelength) is used to irradiate the newborn. This leads to the bilirubin being converted from its previously insoluble form (“unconjugated”) to a water-soluble form (“conjugated”) and thus to excretion via the bile and urine.Thus, the step is taken which the immature enzymes of the child’s liver are not able to handle in full activity. However, strict attention must be paid to adequate protection of the eyes from radiation and sufficient fluid intake during phototherapy, since newborns lose fluid through increased sweating.
If no satisfactory result is achieved by phototherapy, exchange transfusion can then be attempted as a further therapeutic measure, especially in the case of icterus due to blood group incompatibility between mother and child. This usually happens when the mother has a rhesus negative blood group and the child has a rhesus positive blood group, so that the mother forms antibodies against the child’s blood group trait, which then leads to the destruction of the child’s red blood cells. In exchange transfusion, blood is taken from the newborn via the umbilical vein and rhesus negative blood is given until all the blood of the newborn is exchanged.
This is to prevent further decay of the blood cells and an increase in bilirubin levels. Among the remedies used in homeopathic therapy or for the prevention of neonatal jaundice are various substances: On the one hand, phosphorus can be given, which is considered the main remedy. In addition, China, a homeopathic remedy made from the bark of the Chinese tree, which is often used in cases of blood group incompatibility, as well as Lycopodium (pollen of the club moss) and Aconitum (wolfsbane) can be applied. Further interesting information on this topic: An overview of all topics in pediatrics can be found here: Pediatrics
- Blood group incompatibility
- Rhesus factor intolerance
- Rhesus System
- Jaundice
- Jaundice therapy
- Hemoglobin
- Infantile Cerebral Palsy
