Jaundice in Newborn Flashcards
defn of physiologic jaundice
total bilirubin level ≤ 15 mg/dL (≤ 257 μmol/L) in full-term infants who are otherwise healthy and have no other demonstrable cause for elevated bilirubin
Pathophys of breastfeeding jaundice
The low enteral intake results in decreased gastrointestinal motility that in turn promotes retention of meconium.
The β-glucuronidase in meconium deconjugates bilirubin and the unconjugated bilirubin is reabsorbed via the enterohepatic circulation, causing an elevation of serum levels.
pathophys of physiologic jaundice
Increased bilirubin production (from the breakdown of the short-lived fetal red cells) with Relative deficiency of hepatocyte proteins and UDPGT Lack of intestinal flora to metabolize bile High levels of β-glucuronidase in meconium Minimal oral (enteral) intake in the first 2-4 days of life, resulting in slow excretion of meconium (especially common with breastfed infants).
pathophys of breastmilk jaundice
β-glucuronidase present in breast milk deconjugates bilirubin in the intestinal tract; the unconjugated bilirubin is then reabsorbed via enterohepatic circulation.
Time line of physiologic jaundice, breastfeeding jaundice and breastmilk jaundice
physio = dol 2-3 with peak at 3-4 feeding = first week milk = 4-7 days, peak 10 to 14
Antibody-negative hemolysis occurs in infants who have
- red cell membrane defects (e.g., spherocytosis)
2. red cell enzyme defects (glucose-6-phosphate dehydrogenase or pyruvate kinase deficiency).
coobs + with
ABO or Rh incompatibility
Inborn errors of metaboliam that caan cause jaundice
galactosemia
Crigler-Najjar (deficient or completely absent UDPGT)
hypothyroid
major carb in BM and formula
lactose **lactose intolerane rare in first year of life
Why it is important that an infant empty the breast before going to the next breast.
The lipid concentration in breast milk increases as the nursing episode proceeds
type of protein in breast milk
whey
why is cows milk bad for kids < 12 mo
Unmodified cow milk contains approximately three times the protein content of human milk
G6PD def is most common in what race
Mediterranean (causes hemplysis)
how often should babies pee?
The baby should void 3-4 times a day by the third day, and at least 6-8 times a day by the sixth day of life.
cephalohematoma vs caput succedaneum
hematoma = does not cross suture line (is blood and will inc bili as it is abs)
caput succedaneum = swelling crosses suture lines (is serum, not blood)
**both appear after traumatic birth
