Bilirubin: the norm in a newborn. Table by months

The situation when bilirubin in the blood of newborns exceeds the normative indices is not uncommon. Most often, a similar phenomenon occurs on its own. However, too high rates require additional treatment, since they can lead to significant complications. Therefore, it is worth treating extremely high bilirubin.

The concept of bilirubin

Bilirubin is a product formed as a result of the breakdown of red blood cells. If the cycle of their existence has already been completed, they turn into a toxic hemoglobin, from which the dye is formed.

In medical practice, it is customary to distinguish two types (fractions) of this substance: direct and indirect. Initially, indirect bilirubin is formed. It is slightly soluble and difficult to remove from the body. Therefore, first bilirubin is converted into a straight line, which enters the liver, then into the gallbladder and is eliminated through the intestine.

The human body exerts maximum efforts to get rid of this substance. However, the baby's liver is initially unable to cope with such a load. That is why in the first days of life it is so important to monitor whether there is a norm of bilirubin in the blood of newborns. The table in which the threshold values of the indicator are collected is designed to help do this.

The causes of increased bilirubin

The situation poses a threat to the health of the child, when the significance obtained in the course of analysis from the norm of bilirubin in newborns differs by day. A table that compares these two indicators was developed during a lengthy study. Its purpose was to identify the causes that cause this phenomenon. The main ones are:

- abnormalities in the rate of intrauterine development;

- treatment of pregnant women with toxic drugs, as well as their use during childbirth;

- refusal of breastfeeding;

- Too much weight loss in the first days of life.

Children born to women with a negative Rh factor are also at risk. They often show an excess when comparing: the result of the bilirubin test is the norm in the newborn (table).

Norm

A newly born child does not yet have all the organs working at full capacity. Therefore, the fetal hemoglobin formed during the decay does not have time to contact the albumin quickly. As a result, bilirubin levels increase.

At the same time, the amount of substance in the blood first increases, then begins to decrease. In a normal situation, approximately on the fourth day of life, children have minimal bilirubin. The norm in the newborn (the table, which is presented below contains its values) changes significantly with age.

The norm of total bilirubin according to the reference book Ingleleib M.

Age of child	The normal value of the indicator, Μmol / l
First day	Less than 34
1-2 days	24-149
3-5 days	26-205
5 days-60 years	5-21

There is also one more table, in which the data on the normal level of bilirubin in the distribution by fractions are summarized.

Age of child	The value of bilirubin, μmol / l
	General information	Connected	Free
Newborns	23.09	8.72	14.37
Second day	54.22	8.72	45.50
Fourth day	90.14	7.87	82.27
Sixth day	69.10	7.72	63.28
Ninth day	53.02	8.72	44.30
Month	11.12	2.57	8.55

During the birth of the baby, the threshold value of the substance can reach 51 μmol / l. Subsequently, it gradually increases, and on 3-4 days of life reaches a maximum. In children born on term, the level of bilirubin should not be higher than 256 μmol / l, in preterm infants - 171.

Physiological jelly

Often there is a physiological yellowing in newborns. The norm of bilirubin (the table confirms this) grows in the first days of life, however the amount of the substance must independently decrease by the age of half a month.

Doctors identify a number of signs that allow us to talk about the child's physiological jaundice:

- manifested on the second day of life;

- the norm of the content in the blood of bilirubin is exceeded insignificantly;

- on the face and body above the navel, yellowing of the skin is noted.

Despite everything, the child's condition remains absolutely normal, physical activity is maintained. The level of bilirubin should be continuously monitored by a pediatrician so that physiological jaundice does not develop into a pathological jaundice. Normally, at the age of one week, the amount of substance must begin to decrease. At about 3 weeks, the children who were born on time, and by the month of the preterm, normalize bilirubin in the body.

Pathological jaundice

Very quickly, physiological jaundice can go into a pathological jaundice. Heavy forms are accompanied by a significant increase in the level of bilirubin: almost 90 μmol / l every 24 hours. In addition, neonates may initially have a very high value: more than 250 μmol / l.

That is, in such a situation the amount of substance in the blood is much higher than the norm of bilirubin in newborns. The monthly table helps to compare these indicators and determine the problem in time. But there are other signs of pathological jaundice:

- yellowing of the body surface below the navel;

- the orange color of the palms, as well as the feet;

- dark urine and too light feces.

The disease is usually lingering and flows wavy. In addition, the general condition of the child may be disrupted: there is oppression, as well as excessive excitement.

Types and causes of pathological jaundice

There is a wide variety of types of pathological jaundice. They are allocated depending on the causes of the appearance.

1. Hemolytic is manifested in the conflict of the Rh factor in the baby and mother, as well as genetic diseases.

2. Parenchymal jaundice occurs when the liver is affected by congenital forms of hepatitis, cytomegalovirus, toxins.

3. The conjugation type is manifested in the case of abnormalities in the performance of the enzyme system, as well as binding of bilirubin.

4. Mechanical jaundice occurs when the outflow of bile is broken in the anomalies of the gallbladder, as well as the hepatic ducts.

Determination of bilirubin level

To assess the level of the coloring matter in the blood, a special analysis is used. The sample is usually taken on an empty stomach. But this requirement is rarely presented to children, in extreme cases, it is recommended not to feed the baby 4 hours before taking blood. In newborns, samples are taken from the heel into a special vacuum small tube.

To fully analyze the situation, the blood content of all bilirubin fractions is determined. This helps to establish not only the type of jaundice, but also the reasons for its transition to a pathological stage.

After receiving the results of the analysis they are compared and the norm of bilirubin in newborns. The monthly table contains threshold values. If the amount of colorant significantly exceeds them, the situation necessarily requires treatment.

Possible consequences

High concentration in the blood adversely affects the health of the baby. In particular, this refers to the situation when the norm of bilirubin in newborns is not restored (2 months). The table makes it clear that by this age the value should correspond to that which occurs in an adult healthy person.

First of all, high bilirubin is dangerous for the brain, as well as for the nervous system of the child. The danger is that the colorant can accumulate here. Such a situation can lead to a strong intoxication of the body and, as a result, death of brain cells and nerve endings. Subsequently, this can lead to problems with hearing and vision, mental disorders, dementia and other problems.

All this leads to the fact that the pediatrician continuously monitors the possible presence of a jaundice in a child. At the slightest suspicion, a blood test is done, on the basis of which it becomes clear whether the values of the pair "revealed bilirubin is the norm in the newborn". The table at the same time helps doctors make the right conclusion.

Parents are important to know that there are several symptoms, the manifestation of which in a child with jaundice should be an occasion for an urgent call to a doctor. They include:

- lethargy and drowsiness;

- reduction of the sucking reflex;

- cramps, tics, restless behavior;

- Increase in the size of the spleen and liver;

- Lowering blood pressure.

Methods of lowering the level of bilirubin

It is important to understand that physiological jaundice does not require treatment. It must pass by itself. However, treatment can not be avoided if the bilirubin (a norm in a newborn) is significantly exceeded. The table allows not only specialists, but also parents to understand the need for medical intervention.

Begin the fight with high bilirubin followed by light exposure. It is carried out in a special cuvette with mandatory use of protective glasses. This method is considered the most innocuous, but at the same time quite effective and fast. Side effects of this procedure can be diarrhea and skin peeling. In the case of cessation of treatment, the negative consequences from it very quickly come to naught.

However, one should know that phototherapy is effective only in physiological jaundice. If, over time, the level of the substance is higher than the value found in the line "The norm of bilirubin in newborns is 1 month" (the table is presented above), without medicamental treatment it will not be possible to manage anymore.

Many people do not consider jaundice in newborns a serious enough problem. But it is worthwhile to know and understand that this is not always true in all cases. Without proper attention and treatment, the problem can have serious consequences.