It usually occurs 2~4 days after birth, and the serum total bilirubin level of full-term infants usually does not exceed 220.6 micromol/L (12.9 mg/dl), and most of them resolves within 2 weeks.

The total bilirubin level of preterm infants is generally less than 255 micromol/L (15 mg/dl), which can be delayed until 3~4 weeks.

Pathologic jaundice

Abnormal serum bilirubin levels can be caused by a variety of reasons, including excessive bilirubin production, impaired bilirubin metabolism or bile excretion disorders in the liver, which require timely intervention to prevent brain damage caused by excessive bilirubin.

Neonatal jaundice is suspicious of pathological jaundice when the following conditions occur:

jaundice within 24 hours of birth;

Serum bilirubin is elevated > 85 μmol/L per day;

Serum total bilirubin > 220.6 micromol/L (term infants), > 255 micromol/L (preterm infants);

serum conjugated (direct) bilirubin > 34 μmol/L;

Jaundice lasts for > 2 weeks in term infants and 4 weeks > in preterm infants;

recurrence after jaundice has resolved;

Jaundice occurs with unexplained neurological symptoms.

At present, in the field of neonatology, the standard used to evaluate early neonatal jaundice is no longer a single serum bilirubin level, but a temporal bilirubin curve, and it will be particularly combined with the cause of hyperbilirubinemia when judging the harmfulness and danger. ”

The doctor who led the team explained to Ji Xiaohe in detail the professional term jaundice.

A group of pregnant women who accompanied them also gathered around and listened with relish.

At this moment, I saw a nurse bring in a baby from the outside, and then carried the baby to a disposal room inside.

In the disposal room, the nurse placed the baby on the table, and another doctor took a very thick needle and began to draw blood from the baby's foot.

Ji Xiaohe saw that such a thick needle pierced the baby's heel, and he didn't dare to look at it anymore.

Molly and Wen Jing also saw this scene inside, and they were also scared enough by this operation inside.

"The doctor can draw so much blood for such a child, and it's such a thick needle!

It's scary to look at! What are you doing here? Wen Jing asked.

The doctor who led the team smiled when he saw the scene inside, and then explained to Wen Jing.

"The heel blood collection time is within 3~7 days of birth, and the newborn is fully breastfed.

For those who do not have blood collected for various reasons (premature infants, low birth weight infants, early discharge, etc.), it should not be more than 20 days after birth at the latest.

Neonatal disease screening involves collecting newborn heel blood from the delivery hospital (blood is dropped on a special piece of paper and sent to a neonatal disease screening center for testing).

1. Hold the soles of the feet with the left hand;

2. When collecting blood, the left hand holds the sole of the foot and squeezes, and at the same time the right hand holds the ipsilateral calf, with moderate force and intermittent relaxation;

3. Use the index finger and middle finger of the left hand to clamp the calf from the rouge socket along the saphenous vein down to the ankle joint to clamp it to collect blood and prevent blood from returning

4. Warm the feet, no need to squeeze to let the blood flow out naturally;

5. After bathing, use a warm towel to collect blood from a local hot compress at the blood collection point;

6. On the basis of routine blood collection, the newborn should be regularly breastfed, bathed, and collected blood after alcohol massage on the heel.

Detect content

PhenylketonuriaPhenylketonuria (PKU) is an autosomal recessive disorder.

It is named because of the baby's phenylalanine metabolism disorder, and a large amount of phenylpyruvate and other metabolites are excreted in the urine.

Phenylalanine is one of the essential amino acids in the human body, and after ingestion into the body, some of it is used by the body for protein synthesis, and the rest is converted into other substances.

Phenylalanine cannot be metabolized normally in the baby's body, but accumulates in the body, causing damage to the central nervous system and a series of pathological changes.

Sick signalsAffected babies will gradually develop nervous system abnormalities such as hair turning from black to yellow, skin turning white, iris of the eyes becoming lighter, increased muscle tone, abnormal gait, subtle tremor of the hands, and repetitive movements of limbs.

In particular, parents should pay attention to the very unpleasant smell of rat urine in the baby's urine.

In addition, babies are also prone to eczema, vomiting, diarrhea, etc.

In terms of treatment, a low-phenylalanine diet should be used to ensure the supply of various nutrients needed for the normal growth and development of the baby, and to avoid excessive intake of phenylalanine.

Once the diagnosis is confirmed, it should be treated immediately, and the earlier the treatment, the better the prognosis.

TIPS [1]

1. Be sure to strictly control the baby's diet according to the doctor's requirements, phenylalanine can neither be too much nor too little, and insufficient supply of phenylalanine will also lead to growth retardation.

2. Adjust the recipe regularly, generally the baby under 1 year old adjusts the recipe once a month, the one over 1 year old can be adjusted once every 2 months, and the school-age children can be adjusted once every 3~4 months.

3. Breastfeeding under the guidance of a doctor, do not stop breastfeeding.

4. Regularly recheck the phenylalanine concentration in the baby's blood, and conduct physical development and intellectual development examinations for the baby every 6 months to 1 year.

5. Treatment is at least until puberty is mature, and it is best to treat it for life.

6. When a female PKU baby reaches the age of childbearing, it is necessary to strictly control the diet and monitor the blood phenylalanine concentration in the first half of pregnancy until delivery, so as not to affect the development of the fetal nervous system.

7. The prevention method of phenylketonuria is to avoid marriage between close relatives; Couples with PKU babies should have genetic testing for both husband and wife before becoming pregnant again, and genetic testing for the fetus after pregnancy.

HypothyroidismHypothyroidism (CH) is caused by congenital factors that reduce the secretion of thyroid hormones, resulting in growth disorders and mental retardation in babies.

Neonatal disease signals: the main manifestations are not moving, not crying, poor response, sleeping, low muscle tone, in addition to often feeding difficulties, abdominal distention, constipation, prolonged physiological jaundice, low body temperature, etc.

After 3 months, the following features gradually appeared: bloated face, wide eye distance, flat nasal bones, large, thick tongue that often protruded out of the mouth, and dry hair.

Special posture: short stature, upper body larger than lower body, large head and short neck.

Special standing and walking posture: lumbar spine protrusion, knee flexion, walking and swaying. Special development: the baby's head-up, sitting, walking and teething are late, the anterior fontanelle closes late, and the intelligence is backward.

The treatment of this condition is very simple, and the baby can be given thyroxine supplements.

TIPS [1]

1. Early treatment can prevent the child from becoming disabled.

2. You must insist on long-term treatment, and you cannot increase or decrease the dosage or interrupt the treatment by yourself.

3. There is no effective preventive measure for this disease. Therefore, early detection, early treatment and long-term persistence are very important.

Congenital adrenal hyperplasia is also known as adrenogenital syndrome or adrenal allergy.

It is mainly due to defects in enzymes necessary for the biosynthesis of adrenocorticosteroids, resulting in abnormal corticosteroid synthesis.

Therefore, there are different degrees of adrenal insufficiency in clinical practice, accompanied by virilization in girls, and precocious puberty in boys, in addition to a variety of symptoms such as hyponatremia or hypertension.

Treatment should be treated with hydrocortisone or prednisone as soon as possible; Lifelong medication or surgery should be adhered.

Glucose-6-phosphate dehydrogenase deficiency is an inherited metabolic defect that occurs in an incomplete dominant manner with X-related sex, and occurs more often in males than females.

Because there are many variants of G6PD deficiency, the clinical manifestations vary greatly, mild ones can have no symptoms, severe cases can manifest as congenital non-spherocyte hemolytic anemia, generally manifested by taking certain drugs, broad beans or inducing acute hemolysis after infection, and severe ones can be life-threatening.

Prevention is the focus of this disease.

Patients who are diagnosed should abstain from eating fava beans and certain medications thereafter. ”