What to do about neonatal jaundice? Should Yinzhihuang be used?

Naotao G, I heard that Yinzhihuang Oral Liquid cannot reduce jaundice in babies. Is this true? Regarding this issue, Naodao G found an old friend, a pediatric clinician @白衣婆, to talk about the use of Yinzhihuang! Yinzhihuang has a long history of being used to treat jaundice. Perhaps, we cannot fully judge the characteristics of traditional Chinese medicine from the perspective of Western medicine. However, with the development and accumulation of clinical medicine and evidence-based medicine, the management of many traditional Chinese medicines in our country has become more and more formal and strict to avoid the occurrence of some possible side effects. Recently, another mother is consulting: The baby is just 6 days old and has yellowish skin for 4 days. The mother is a patient with G6PD deficiency. Can she give her baby Yinzhihuang oral liquid or injection? Here, I quote two notices from the State Food and Drug Administration to answer: (Search results for \”Yinzhihuang\” from the State Food and Drug Administration) 1. Yinzhihuang injection is prohibited for newborns and infants. The revision requirements for injection instructions mention: Neonates, infants and young children are prohibited from using 2. Yinzhihuang oral liquid. In view of the fact that Yinzhihuang oral preparations have cases of hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, currently The correlation cannot be determined and further research is needed. It is recommended that patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency use caution in the use of Yinzhihuang oral preparation instructions. The revised requirements for the instructions for Yinzhihuang oral preparations mention: patients with G6PD deficiency should use it with caution. Then, neonatal jaundice, How should it be treated? In fact, regarding the diagnosis and treatment of diseases, we clinicians pay attention to the latest scientific clinical research results and the diagnosis and treatment guidelines of national expert groups in relevant disciplines. Regarding neonatal hyperbilirubinemia (also known as neonatal jaundice), the Neonatology Group of the Pediatric Branch of the Chinese Medical Association updated a guideline in 2014, \”Expert Consensus on the Diagnosis and Treatment of Neonatal Hyperbilirubinemia\” \”, which mentions treatment methods, there are actually three types: 1. Phototherapy: When the child\’s bilirubin index reaches the phototherapy standard, blue light irradiation treatment is used. (During neonatal blue light incubator treatment, the eyes and perineum should be shielded and protected) 2. Drug treatment: ① For those diagnosed with neonatal hemolytic disease, such as ABO-incompatible hemolysis and RhD-incompatible hemolysis, gamma globulin can be used; ② When the serum cholesterol Newborns whose red pigment level is close to the exchange transfusion value and whose albumin level is <25g/L can supplement 1g/kg of albumin to increase the connection between bilirubin and albumin and reduce free bilirubin in the blood. 3. Exchange transfusion treatment: When a child\'s bilirubin index exceeds the exchange transfusion line, exchange transfusion treatment may be considered based on the patient\'s condition. It can be seen from the above-mentioned expert consensus that in clinical practice, the treatment of neonatal hyperbilirubinemia in most regular hospitals mainly includes the above three treatment methods. The treatment of neonatal jaundice does not include the use of Yinzhihuang. 1. Yinzhihuang injection is prohibited; there is no objection to this, and the instructions have been updated! 2. In the regular treatment of neonatal jaundice, there is no need to use Yinzhihuang oral liquid, and the oral liquid itself may also potentially cause aggravation of jaundice in children with favismosis (G6PD) and increase the risk of diarrhea in babies. As a pediatrician, I also Daddy,In order to avoid risks, Yinzhihuang Oral Liquid will not be used. “Some parents say that if you don’t use Yinzhihuang for your baby, will there be no medicine available?” Answer: It’s not that there is no medicine available, but that there is no need for medicine… Since the standard of phototherapy treatment is not met, why should medicine be given to the baby? ? \"If the doctor prescribes this medicine, can I refuse it?\" Answer: Parents are worried about its side effects and can refuse to use it. They can also directly explain to the doctor that the baby\'s gastrointestinal tract is relatively fragile and is afraid of causing diarrhea and other diseases. If the jaundice is relatively mild, you can consider dynamic observation and go to the hospital for a review of bilirubin in 2-3 days. \"My baby has been drinking Yinzhihuang for 2 months. Will it be okay? Is there any other harm to the baby besides diarrhea?\" Answer: After taking the oral liquid for 2 months, it does take a long time. If there is no diarrhea now, There should be little impact in the later stage. You can just continue to observe. Just pay attention to nutrition, hygiene and cleanliness in your diet. Regarding other injuries, there is no clear information for the time being. It is recommended to continue to observe. There is no need to worry. Here, regarding neonatal jaundice, based on clinical experience, I would like to give you some tips for your reference: 1. After the baby is born, at least within a week, parents should pay attention to check the baby\'s skin for jaundice. , should be observed every day to avoid lack of careful observation caused by indoor darkness and poor lighting. It is best to observe under natural light; 2. If the baby\'s skin jaundice feels that it is progressing quickly, seek medical treatment as soon as possible, even if you find a regular hospital nearby for pediatric (neonatal) care. Pediatrics) doctor \"take a look\" (actually a visual examination), which is at least safer; (the doctor will help you take a look at the baby\'s overall condition first, and will help you monitor the bilirubin level if necessary) 3. If the baby\'s mother is For type O blood, if the father is type A, B or AB, the baby will have a higher probability of developing jaundice; if the baby\'s mother has RhD negative blood, the baby will have a higher probability of developing jaundice. Parents should pay attention to these situations; 4. If there is a patient with G6PD deficiency in the family (including the mother and the father), the baby may also suffer from G6PD deficiency (G6PD deficiency, referred to as \"faba disease\", is a disease that can easily cause hemolysis.), this Babies from similar families are also more likely to have jaundice. I once saw a baby who was about 10 days old. Because the jaundice was already very severe, he only came to see the doctor when he developed kernicterus (bilirubin encephalopathy). Ask the parents why they didn’t come earlier? Reasons given by parents: including \"confinement, pre-month, etc.\" The bedroom windows of confinement homes are rarely opened and the lights are dim. Parents fail to carefully observe the child\'s skin condition, causing neurological sequelae for the baby\'s life. It\'s really heartbreaking. To sum up, if the baby is just born, parents are asked to carefully observe the daily changes in jaundice; if the baby has already developed jaundice and is gradually getting worse, parents are asked to take the baby to a local regular hospital for treatment as soon as possible. In the treatment of neonatal jaundice, there is no need to use Yinzhihuang oral liquid. Wish all the babies in the world happiness and health~