bubble_chart Concept

Neonatal jaundice refers to the condition where a newborn's skin, face, and urine all exhibit a yellow coloration.

Ancient texts have recorded various names for this condition, such as Zhubing Yuanhou Lun referring to it as "fetal jaundice"; 《Infant and Child Hundred Questions》 also calls it "fetal jaundice".

Within 2 to 5 days after birth, if a baby's face and entire skin turn yellow, with some cases being mild and others more severe, but the baby's spirit, appetite, and sleep are all normal, this is considered physiological jaundice and will not be discussed further. For babies over a hundred days old up to six months, if they show slight yellowing of the skin and face without any illness or other symptoms, this is a manifestation of stomach heat and also does not fall within the scope of this condition.

bubble_chart Pattern Analysis

1. Dampness-heat︰The face and skin appear yellow, with a bright orange hue. Sweat and urine resemble Gardenia water, staining objects yellow. There is fever, thirst, and a desire to drink water, abdominal distension, grayish or constipated stools, mental fatigue, reluctance to consume milk or food, a yellow and greasy tongue coating, and purple stagnant finger veins. There are similarities and differences with physiological jaundice, which must be distinguished. Their common points are: (1) yellowing of both eyes; (2) yellowing of the entire body's skin. The differences are: (1) dampness-heat jaundice has no fixed timing, whereas physiological jaundice mostly occurs within 2 to 5 days after birth; (2) dampness-heat jaundice is deep in color and does not resolve on its own, whereas physiological jaundice is light in color and can resolve spontaneously; (3) dampness-heat jaundice is accompanied by symptoms of excess heat such as fever, thirst, constipation, dark urine, and purple stagnant finger veins, whereas physiological jaundice is not accompanied by other symptoms.
2. Cold-dampness︰The face and skin appear yellow, with a dull and lusterless yellow hue, or a dark yellow like smoke staining, accompanied by mental fatigue, somnolence, reluctance to breastfeed, abdominal distension and fullness, grayish-white or loose stools, scanty dark urine, and a white greasy tongue coating, with pale red finger venules. Both dampness-heat jaundice and cold-dampness jaundice are related to pathogenic dampness. If the mother harbors dampness-heat toxins that are passed to the fetus, or if the infant is exposed to dampness-heat after birth, leading to accumulation in the spleen and stomach and steaming of the liver and gallbladder, bile may leak out and overflow into the skin, resulting in jaundice. This is called "yang jaundice." If the child has a congenital deficiency, with spleen-stomach yang qi deficiency and inability to transport dampness turbidity, leading to internal cold transformation, or if yang jaundice is prolonged and untreated, damaging yang qi and causing internal obstruction of cold-dampness, the body may also turn yellow. This is called "yin jaundice." The key points for differentiation are: yang jaundice presents with a bright yellow color like orange, accompanied by fever, thirst, chest tightness, abdominal distension and fullness, constipation, and a yellow greasy tongue coating—symptoms of excess heat; yin jaundice presents with a dull yellow color like smoke staining, accompanied by fear of cold, cold limbs, poor appetite, loose stools, and a white greasy tongue coating—symptoms of deficiency-cold. Treatment for yang jaundice varies depending on whether heat or dampness predominates. For cases where pathogenic heat is dominant, the method involves clearing heat and draining dampness, supplemented with purging to resolve jaundice from within. The representative formula is Virgate Wormwood Decoction. For cases where dampness is dominant, the method involves removing dampness and eliminating turbidity, supplemented with clearing heat to resolve jaundice through urination. The representative formula is Powder of Capillaris and Five Ingredients with Poria. Treatment for yin jaundice differs between deficiency-cold of the spleen and stomach and spleen-kidney yang deficiency. The key points for differentiation are: abdominal distension and fullness with reduced appetite, fear of cold, and loose stools indicate deficiency-cold of the spleen and stomach. The method involves warming the spleen and draining dampness, with the representative formula being Virgate Wormwood Middle-Regulating Decoction. If symptoms include cold limbs, grayish-white stools, and clear urine, this indicates kidney yang deficiency. The method involves warming the kidneys and draining dampness, with the representative formula being Virgate Wormwood Cold-Extremities Decoction.

Additionally, if a newborn exhibits a yellowish complexion resembling smoke staining shortly after birth, which persists and gradually worsens over 4 to 5 months without improvement, accompanied by a dull complexion, refusal to feed, abdominal distension and fullness, shortness of breath, and pale stools, this is indicative of yin jaundice, related to fetal endowment. Clinically, such cases are notably difficult to treat.

bubble_chart Documentation

1. Zhubing Yuanhou Lun．Miscellaneous disease in pediatrics: "When a child is in the womb, if the mother's visceral energy is hot, it steams the fetus. After birth, the child's body turns yellow, which is called fetal jaundice."
2. Xiao'er Yaozheng Zhijue．Similar to yellow: "There are also those who are born with a yellow body, which is fetal jaundice."
3. 《Yingtong Baiwen．Fetal Diseases》: "The symptoms of fetal jaundice are that the child is born with a yellow body and face, resembling gold, with high fever, constipation, urine like Gardenia juice, refusal to eat, and incessant crying. This is all due to the mother's heat being transmitted to the fetus. For such symptoms, the nursing mother can take Unprocessed Rehmannia Root soup, and should avoid heat-toxic substances."