morphine and Jaundice--Neonatal

Delayed passage of meconium may increase enterohepatic circulation of bilirubin, which appears to be an important contributor to neonatal jaundice. To evaluate the effect of early meconium evacuation on neonatal hyperbilirubinemia, between January 1993 and December 1993, 265 healthy neonates were studied and randomly divided into two groups. Group 1 consisted of 130 neonates who received glycerin enema (1 mL of glycerin mixed with 1 mL of warmed normal saline) within 30 minutes after birth and the same procedure was repeated at 12 hours of age. Group 2 consisted of 135 neonates receiving no glycerin enema throughout their hospital stay. Determination of total serum bilirubin using capillary samples was performed daily for 7 days. Our data showed that 12 neonates (15.4%) in group 1 and 18 neonates (13.3%) in group 2 had serum bilirubin level 15 mg/dL or higher and received phototherapy. We conclude that early evacuation of meconium by using glycerin enema within 30 minutes after birth and 12 hours after birth in order to reduce enterohepatic circulation of bilirubin has no effect on lowering peak serum bilirubin levels or on serum bilirubin concentrations in the first 7 days of life.

Topics: Bilirubin; Enema; Glycerol; Humans; Infant, Newborn; Jaundice, Neonatal; Meconium

Delayed passage of meconium has been associated with hyperbilirubinemia. To determine if early evacuation of meconium is effective in reducing total serum bilirubin level, 84 term healthy neonates were randomly assigned to a suppository group or a nonsuppository group. Use of suppositories resulted in earlier evacuation of meconium as measured by the appearance of transitional stool. No significant effect was noted, however, on total serum bilirubin levels in the first three days of life. Routine use of suppositories to decrease total serum bilirubin level cannot be recommended for term healthy neonates.

Topics: Bilirubin; Glycerol; Humans; Infant, Newborn; Jaundice, Neonatal; Meconium; Random Allocation; Suppositories

Neonatal jaundice is a common disease that affects up to 60% of newborns. Gut microbiota mediated the excretion of bilirubin from the human body. However, the relationship between early gut microbiome and development of neonatal jaundice is not fully understood. Here we sought to characterize meconium microbiome of newborns and to clarify its association with risk of neonatal jaundice.. We conducted a nested case-control study with 301 newborns providing meconium samples from 2014 to 2015. The main outcome was the development of neonatal jaundice at 42 day follow-up. 16S rRNA gene sequencing was performed to profile the meconium microbiome. LEfSe was employed to identify different features between control and case groups. Logistic regression was used to estimate the risk effect of early gut microbiome on neonatal jaundice.. Logistic regression models suggested that higher ɑ-diversity was significantly associated with lower risk of jaundice in cesarean infants (OR 0.72, 95% CI 0.52-0.98), but not in infants born naturally. Higher relative abundance of Bifidobacterium pseudolongum in newborn meconium was significantly associated with lower risk of jaundice both in cesarean-born infants and in the total subjects (OR 0.24, 95% CI 0.07-0.68; OR 0.55, 95% CI 0.31-0.95, respectively). Spearman's correlations showed that relative abundance of B. pseudolongum was significantly correlated with ɑ-diversity (P < 0.01).. Preventive and treatment methods implying early gut microbiome intervention could be promising for the management of neonatal jaundice.

Topics: Adult; Bifidobacterium longum; Bilirubin; Case-Control Studies; Cesarean Section; Female; Gastrointestinal Microbiome; Humans; Infant, Newborn; Jaundice, Neonatal; Logistic Models; Male; Meconium; Pregnancy; Risk Factors

Topics: Adult; Amniotic Fluid; Apgar Score; Gestational Age; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Israel; Jaundice, Neonatal; Meconium; Meconium Aspiration Syndrome; Patient Admission; Phototherapy; Respiration Disorders; Respiration, Artificial; Respiratory Distress Syndrome, Newborn; Retrospective Studies; Risk Factors; Sepsis; Tachypnea; Term Birth; Young Adult

The effects of kaisailu defecation on alleviating neonatal jaundice were studied. 203 case of newborns fed with total mother breast milk were divided into two groups: experimental group (100 cases) received routine treatment and kaisailu (10 ml per rectum) control group (103 cases) only received routine treatment. The findings were as follows: excretory time of meconium in experimental group was more ahead than that in control group; the excretory meconium volume of the first time was obviously higher in experimental group; time of meconium changed yellow was distinctly shorter and the bilirubin index (measured by transcortical bilirubin method) lowered more rapidly in experimental group than that in control group. The results suggested that kaisailu defecation can alleviate neonatal jaundice.

Topics: Defecation; Drugs, Chinese Herbal; Humans; Infant, Newborn; Jaundice, Neonatal; Meconium

Between 1960 and 1994 cystic fibrosis was found in nine out of 1474 infants investigated for neonatal cholestasis. Four had delay in passing meconium. In all patients cholestatic jaundice was present during the first 48 hours and in three patients cholestasis was complete, mimicking biliary atresia. Serum cholesterol concentrations were normal in all but two children. Sweat chloride was repeatedly above 95 mmol/l in all instances. Three children had another condition enhancing the risk of cholestasis (alpha1-antitrypsin deficiency, hypopituitarism, perinatal asphyxia, and total parenteral nutrition). Liver histology displayed portal fibrosis and inflammation with bile duct proliferation; mucous plugs in bile ducts were observed in only one patient. Only one child died from cirrhosis. These results indicate that cystic fibrosis is not a major cause of neonatal cholestasis. However early signs of intestinal obstruction and low concentrations of serum cholesterol may indicate cystic fibrosis, regardless of liver histology. Neonatal cholestasis has no prognostic value concerning evolution to cirrhosis.

Topics: Cholestasis; Cystic Fibrosis; Female; Humans; Infant; Infant, Newborn; Jaundice, Neonatal; Liver; Male; Meconium

'Idiopathic' hyperbilirubinaemia in the first 4 days of life was studied in 431 unselected healthy full-term (gestational age > or = 37 weeks) singleton Sardinian infants with birthweight > or = 2500 g. All infants were free from malformations or any disease requiring treatment other than jaundice, they were ABO and Rh compatible with their mothers and were not G6PD deficient. The serum bilirubin level was > 11.9 mg/dl (204 mumol/l) and > 14.9 mg/dl (256 mumol/l) in 37.1% and 15.3% of the study subjects. The vast majority of the infants (94%) were breast fed; no difference in the incidence of jaundice was found between breast-fed and bottle-fed infants. A logistic regression analysis indicated that high alpha-fetoprotein concentrations in cord blood, history of neonatal jaundice in previous full-term siblings, delayed first meconium passage and weight loss were associated with jaundice, defined as a serum bilirubin level > 11.9 mg/dl. These results suggest that the high rate of neonatal hyperbilirubinaemia in Sardinia is mostly related to constitutional and possibly hereditary factors.

Topics: alpha-Fetoproteins; Breast Feeding; Female; Humans; Infant, Newborn; Italy; Jaundice, Neonatal; Male; Meconium; Multivariate Analysis; Odds Ratio

The incidence of neonatal jaundice is reported to have increased in relation to breast feeding and various factors are thought to contribute to this either singularly or in concert. In a group of 150 full-term healthy babies, feeding types and gut transit time of meconium were examined. The findings demonstrated significant differences between feeding types and time taken to evacuate total meconium (p < 0.0001), weight loss/gain patterns (p < 0.0005) and the incidence of moderately severe jaundice (p < 0.01) during the early neonatal period. Baby feeding types were clearly defined in the study and a stool colour comparator was used to facilitate identification and classification of all stool colour transition from meconium through to yellow. Maximum weight loss was found to occur on the second day after delivery and in many instances the lost weight was regained by the baby on the fifth day. Exceptions to this were babies who fed ineffectively or inadequately. These outcomes suggest that the assistance and advice given to mothers and babies, by midwives and others, to achieve effective feeding practices in the days following birth is of paramount importance to the baby's immediate wellbeing.

Topics: Bottle Feeding; Breast Feeding; Feeding Behavior; Gastrointestinal Transit; Humans; Incidence; Infant, Newborn; Jaundice, Neonatal; Meconium; Time Factors

Significant or highly significant differences were found between groups of breast and bottle-fed infants with respect to the incidence of jaundice, time to passage of first yellow stool and early weight changes. Experimental parameters were carefully defined, and a simple stool colour comparator has been designed and developed. Breast feeding should be encouraged for its incidence is low in many European countries and it is the responsibility of the attending midwife to ensure that correct suckling techniques are achieved by mothers and infants at the earliest possible time after delivery.

Topics: Body Weight; Bottle Feeding; Breast Feeding; Child Nutrition Sciences; Europe; Feces; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Jaundice, Neonatal; Job Description; Meconium; Mothers; Nurse Midwives; Rooming-in Care; Scotland; Sucking Behavior; Time Factors

Topics: Adolescent; Adult; Ascites; Bile Duct Diseases; Cecal Diseases; Child; Child, Preschool; Colonic Diseases; Cystic Fibrosis; Duodenal Diseases; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Intussusception; Jaundice, Neonatal; Liver Diseases; Male; Meconium; Peritonitis; Prenatal Diagnosis; Tomography, X-Ray Computed; Ultrasonography

A geographically based population of 498 full term, appropriate for gestational age, healthy, singleton neonates was used to study the effect of obstetric and nursery practices on the occurrence of neonatal jaundice. At 3-4 days 56% of babies became visibly jaundiced (plasma bilirubin (PB) greater than 100 mumol/l) and 10% were hyperbilirubinaemic (PB greater than 200 mumol/l). Less mature babies, those slow to pass meconium and those who had lost weight at 4 and 7 days were more likely to be jaundiced. Obstetric practices, drugs given during labour, mother's or baby's blood group, natural illumination, plethora, extravasated blood or mode of feeding were found to have no effect. No benefit from giving supplementary milk or dextrose to breast fed babies was discovered. At 6-7 days at least 9% of babies, all but one of whom were breast fed, were visibly jaundiced. The frequency of prolonged jaundice (breast milk jaundice) was 3.8% of breast fed babies at 3 weeks and zero by 7 weeks. The proportion of babies receiving phototherapy was 2.2%.

Topics: Body Weight; Breast Feeding; Female; Gestational Age; Humans; Infant Food; Infant, Newborn; Jaundice, Neonatal; Male; Meconium; New Zealand; Nurseries, Hospital

The relationship of placental size to perinatal outcome was investigated in a population of low-risk infants. A trimmed and drained placenta was weighed for each of 417 low-risk infants, and for 108 infants whose intrapartum course was complicated only by compression of the umbilical cord. Tracings from intrapartum electronic fetal heart rate monitoring were analyzed by an investigator who was unaware of the fetal weight/placental weight ratio. The incidence of perinatal problems was increased in those infants whose fetal weight/placental weight ratio was greater than 11: intrapartum fetal distress, 20% (p = 0.0046); meconium-stained amniotic fluid, 28.9% (p = 0.0017); Apgar score less than 7, 11.1% (p = 0.04); and hyperbilirubinemia, 24.4% (p = 0.0008). On the basis of these data, the conclusion drawn was that there is a population of presumably low-risk infants who are at increased risk because they have outgrown their placentas.

Topics: Amniotic Fluid; Apgar Score; Birth Weight; Black People; Female; Fetal Distress; Fetal Monitoring; Fetus; Growth; Heart Rate; Humans; Infant, Newborn; Jaundice, Neonatal; Meconium; Organ Size; Placenta; Pregnancy; Prospective Studies; Risk

Topics: Agar; Bibliographies as Topic; Bilirubin; Brain; Enzyme Induction; Estrogens; Glucuronosyltransferase; History, 15th Century; History, 18th Century; History, 20th Century; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Intestinal Absorption; Jaundice, Neonatal; Kernicterus; Lipid Metabolism; Meconium; Microsomes, Liver; Milk, Human; Oxytocin; Phototherapy; Progesterone; Serum Albumin; Solubility

Topics: Centrifugation; Cerebrospinal Fluid; Humans; Infant, Newborn; Jaundice, Neonatal; Leukocyte Count; Macrophages; Meconium

Topics: Congenital Hypothyroidism; Female; Gestational Age; Humans; Hyaline Membrane Disease; Hypothyroidism; Infant, Newborn; Jaundice, Neonatal; Meconium; Thyrotropin; Thyroxine

During a study on the influence of different amounts of fluid intake on water and electrolyte metabolism in the first 3 days of life, a high incidence of hyperbilirubinemia was observed in infants receiving a large water load (150 ml/kg/24 h) intravenously. The amount of meconium excreted during the 3-day period in newborns with total parenteral alimentation was significantly lower than in controls. Hyperbilirubinemia is considered to be due to the enterohepatic circulation of bilirubin present in the retained meconium. The role of slight hemolysis and insufficient stimulation of choleresis is discussed.

Topics: Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Jaundice, Neonatal; Male; Meconium; Parenteral Nutrition; Water-Electrolyte Balance

Topics: Carbohydrate Metabolism; Child, Preschool; Deglutition; Digestion; Digestive System; Digestive System Physiological Phenomena; Fats; Feces; Gastrointestinal Motility; Humans; Immunity; Immunoglobulins; Infant; Infant, Newborn; Jaundice, Neonatal; Liver; Meconium; Proteins; Sucking Behavior; Vitamin B 12

Topics: Autopsy; Bile; Biopsy; Child; Cystic Fibrosis; Female; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Jaundice, Neonatal; Liver; Liver Cirrhosis, Biliary; Male; Meconium

Topics: Amniotic Fluid; Bile Pigments; Bilirubin; Birth Weight; Cesarean Section; Defecation; Female; Humans; Infant, Newborn; Intestinal Absorption; Jaundice, Neonatal; Maternal-Fetal Exchange; Meconium; Pre-Eclampsia; Pregnancy; Time Factors

Topics: Bilirubin; Humans; Infant, Newborn; Intestinal Mucosa; Jaundice, Neonatal; Meconium

Topics: Aspartate Aminotransferases; Bilirubin; Blood Glucose; Cholestasis; Humans; Hypoglycemia; Infant, Newborn; Intestinal Obstruction; Jaundice, Neonatal; Jejunum; Liver; Male; Meconium; Prednisolone