When babies turn yellow

Ng, Mark; How, Choon How

doi:10.11622/smedj.2015167

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Neonatal jaundice is one of the most common manifestations observed during the neonatal period. Breast milk jaundice (BMJ) is the first cause of neonatal jaundice, which is characterized by unconjugated hyperbilirubinemia associated with breastfeeding (1). BMJ presents in the first or second week of life, can persist for as long as 12 weeks, and is generally considered to have a good prognosis.…”

Section: Introductionmentioning

confidence: 99%

Changes in Intestinal Flora and Metabolites in Neonates With Breast Milk Jaundice

Shen

et al. 2020

Front. Pediatr.

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Background: Breast milk jaundice (BMJ) is the first cause of neonatal jaundice; however, its underlying mechanism is yet to be deciphered. We conducted a study to investigate intestinal flora in neonates with BMJ and used metabolomics to decipher the possible mechanisms by which intestinal flora induces jaundice. Methods: Microbiota collected from the feces of BMJ patients and jaundice-free breastfeeding newborns was used for 16S rRNA sequencing. In addition, differences in fecal metabolites were analyzed using gas chromatography mass spectrometry (GC/MS). The relationship between intestinal microbiota and the differences in fecal metabolites was then analyzed. Results: There was no significant difference in the richness and diversity of intestinal flora between BMJ and the control group; however, there were differences in the structure. At the phylum level, the relative abundance of Firmicutes was higher in the control group compared to the BMJ group, whereas Proteobacteria was higher in the infants with BMJ. Additionally, at the genus level, the relative abundance of Haemophilus was higher in the control group, whereas the relative abundances of Escherichia, Morganella, and Rothia were lower. More remarkably, the major differences in metabolites between the two groups were glyceric acid, succinic acid, and phenylalanine. Additionally, the abundance of Escherichia was positively correlated with succinic acid and cadaverine levels. Conclusions: The intestinal flora colonization status in BMJ patients is immature. This study reports for the first time that the study of intestinal flora, especially Escherichia, plays an important role in BMJ, and found that it may be associated with the regulation of succinic acid metabolic pathways.

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Section: Introductionmentioning

confidence: 99%

Changes in Intestinal Flora and Metabolites in Neonates With Breast Milk Jaundice

Shen

et al. 2020

Front. Pediatr.

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“…The management includes a visual assessment of yellowing of the skin and sclera, apathy, reluctance to suck, and reduced urine output. Clinical examination of the infant for jaundice should be done, if possible, in bright, natural light, especially in babies with darker skin tones (11) . This raises the question of whether an experienced investigator is able to assess the level of neonatal jaundice based solely on a visual assessment of the degree of yellowing of the skin.…”

Section: Tab 2 Characteristics Of Infants Included In the Second Stag...mentioning

confidence: 99%

Effect of bilirubin levels in infants on spontaneous activity assessed by the Prechtl method

Witanowska¹,

Jarecka²,

Bugdol³

et al. 2022

Pediatr Med Rodz

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Introduction: Neonatal jaundice is characterised by a yellow coloration of the skin, mucous membranes, and sclera of the eye resulting from the accumulation of bilirubin in the body. When produced in significant excess, bilirubin can accumulate in the central nervous system causing kernicterus (bilirubin encephalopathy). The diagnosis of jaundice based only on the visual assessment of the degree of yellowing of the skin or sclera and the urine output is not a reliable method. Even the assessment by experienced observers does not correlate with actual measurements of serum bilirubin levels. Therefore, a study was undertaken to determine whether other parameters could clarify the diagnosis of neonatal jaundice during the observation of an infant. The aim of this study was to analyse the effect of bilirubin levels on motor activity of the infants studied in terms of the quality of motor patterns assessed using the Prechtl method. Materials and methods: The research procedure was multistage and included a retrospective analysis of neonatal medical records, transcutaneous measurement of bilirubin levels, and analysis of neonatal activity performed based on video recordings. A qualitative assessment of neonatal spontaneous activity was performed using the Prechtl GMA method (general movement assessment). The research procedure consisted of two stages. The first stage involved selecting infants who had a good general health status. Based on these criteria, a total of 125 infants were included in the video recording. The second stage of study inclusion took place after video recording. Infants with short periods of wakefulness, prolonged crying, and lying on their side were excluded from further examinations. Ultimately, 52 infants were included in the study. All infants were subjected to the diagnostic method proposed by Prechtl to determine the effect of bilirubin levels on their motor activity. Conclusion: Bilirubin levels in the course of physiological jaundice did not affect the quality of motor repertoire in the group of infants studied. Therefore further research is needed.

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“…É a expressão clínica da hiperbilirrubinemia, observada quando a bilirrubina atinge valores acima de 4 a 6mg/dL. Pode ser avaliada pela coloração da pele do RN no exame físico utilizando-se a classificação de Kramer, pela dosagem da bilirrubina transcutânea não invasiva e pela dosagem sérica da bilirrubina [2][3][4][5][6] .…”

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2022

Resid Pediatr

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Investigar a frequência da icterícia e do uso de fototerapia, bem como fatores de risco associados à necessidade de fototerapia em alojamento conjunto (AC). Métodos: Estudo retrospectivo com RN de 35 semanas ou mais de idade gestacional (IG) internados em AC de hospital terciário no período de outubro a dezembro de 2017, divididos em dois grupos: tratados e não tratados com fototerapia. Incluídos todos os nascidos no serviço com IG maior ou igual a 35 semanas, sem anomalias congênitas, e admitidos no AC. Excluídos os que necessitaram de internação em enfermaria neonatal. Avaliados dados clínicos maternos, gestacionais, neonatais e práticas assistenciais. Desfecho: uso de fototerapia. Associações entre grupos foram avaliadas pelo teste t-Student e pelo qui-quadrado. Regressão logística múltipla foi empregada para identificar fatores independentes associados ao uso de fototerapia. Resultados: 376 RN estudados. Do total, 176 (47%) tiveram icterícia e destes 66 (18%) foram tratados com fototerapia. O grupo tratado teve menor IG (38 x 39 semanas), maior bilirrubina em sangue de cordão (2 x 1,5mg/dL), maior perda de peso (7 x 6%), incompatibilidade ABO mais frequente (35 x 10%) e internação mais prolongada (79 x 50 horas). Regressão logística identificou como fatores independentes de risco para fototerapia: IG (OR=6), bilirrubina de cordão (OR=16), incompatibilidade ABO (OR=12) e perda de peso (OR=1,24). Conclusão: Icterícia foi frequente nos RN em AC e quase 20% deles realizaram fototerapia. Perda de peso foi o único fator evitável de risco para fototerapia e nenhum fator de proteção foi evidenciado.

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When babies turn yellow

Cited by 12 publications

References 22 publications

Changes in Intestinal Flora and Metabolites in Neonates With Breast Milk Jaundice

Changes in Intestinal Flora and Metabolites in Neonates With Breast Milk Jaundice

Effect of bilirubin levels in infants on spontaneous activity assessed by the Prechtl method

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