Why is the hematocrit level high in newborns, and what should be done?

Generally, elevated hematocrit levels in newborns may be caused by factors such as fetal intrauterine hypoxia, physiological concentration in premature infants, neonatal sepsis, hemolytic disease of the newborn, or congenital heart disease. It is recommended to seek timely medical attention, identify the underlying cause, and then improve the condition through general treatment, medication, or other methods under a doctor's guidance. A detailed analysis is as follows:

1. Fetal intrauterine hypoxia: When a fetus experiences hypoxia in utero, the body compensates by producing more red blood cells to carry oxygen, which can easily lead to elevated hematocrit levels after birth. After birth, it is important to closely monitor the newborn's respiration and heart rate, ensure adequate oxygen supply, and provide oxygen therapy if necessary. Maintaining proper body temperature is also essential.

2. Physiological concentration in premature infants: Premature infants often have reduced blood volume and concentrated blood shortly after birth, which can lead to elevated hematocrit levels. There are usually no other abnormal symptoms. Enhanced feeding and sufficient fluid intake should be ensured, with milk volume adjusted according to weight and age in days to promote blood circulation. Regular monitoring of complete blood count (CBC) is necessary to observe changes in indicators.

3. Neonatal sepsis: Systemic inflammatory response caused by bacterial infection can affect blood metabolism, leading to elevated hematocrit levels, accompanied by symptoms such as fever and reduced feeding or crying. Affected infants should receive treatment with medications such as penicillin sodium for injection, cefotaxime sodium for injection, or vancomycin for injection, as directed by a physician.

4. Hemolytic disease of the newborn: Excessive destruction of red blood cells due to maternal-fetal blood group incompatibility leads to compensatory red blood cell production, causing elevated hematocrit levels along with jaundice and anemia. Treatment should include medications such as human immunoglobulin injection, methylprednisolone sodium succinate for injection, and sodium phenobarbital injection, as prescribed by a physician.

5. Congenital heart disease: Structural abnormalities of the heart cause circulatory disturbances, and tissue hypoxia stimulates increased red blood cell production, resulting in elevated hematocrit levels, often accompanied by tachypnea and feeding difficulties. Cardiac function should be improved using medications such as digoxin oral solution, furosemide injection, and spironolactone tablets, as directed by a physician according to the patient's condition.

In daily care, it is important to strengthen newborn care by maintaining suitable indoor temperature and humidity to avoid chilling or overheating. Closely observe the newborn's mental status, feeding behavior, and skin color, keep track of urination and bowel movement frequency, and schedule regular health check-ups to support the infant's healthy growth.