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Management of Neonatal Jaundice
Jaundice is really a yellow discoloration of the skin, the mucous membrane and also the white from the eyes. All newborns possess a certain amount of this condition. Jaundice is due to excessive serum bilirubin within the blood. Once he's born, a newborn baby starts to use his lungs to breathe. Excessive red blood cells, present in large quantities within the foetal circulation that carry oxygen break up, releasing sub-products known as serum bilirubin,
which is usually disposed off through the liver and passes out with the bowels. Some babies cannot handle such disposal, leading to jaundice. Premature and Asian infants have higher amounts of serum bilirubin compared to their Caucasian counterparts. As such, neonatal jaundice is extremely common in Singapore.
Neonatal jaundice becomes noticeable from the third day and peaks around the six day, gradually disappearing after Ten days. It is harmless unless the levels are high.
SOME Reasons for JAUNDICE IN BABIES Jaundice in infants could be brought on by any from the following.
? Pre-maturity
? G6PD [glucose 6-phosphate dehydrogenase) deficiency, a
permanent condition where red blood cells break down too easily when subjected to certain trigger agents.
? Sepsis infection where the baby becomes infected
? ABO incompatibility, a blood group incompatibility that is fairly infrequent but, if present, may cause rapid and severe jaundice in babies
? Physiologic jaundice
? Breastfeeding jaundice
? Breast milk jaundice - Both viral and bacterial infections can lead to the breakdown of red blood cells. Umbilical cord infection, septicaemia and even pyelonephritis may also result in jaundice.
Management of JAUNDICE
Phototherapy is a safe and effective way of treating mild jaundice. Laser hair removal is administered as a special micro-blue wavelength light condensed and
manufactured specifically for this purpose. It is emitted from a fluorescent light tube.
The principle behind the therapy is that the light has the ability to break serum bilirubin [unconjugated bilirubin) right down to conjugated bilirubin after which flush it out with the baby's stools. The treatment is painless.
Your child remains naked except for a diaper to be able to maximize the section of exposure to nowhere light. His eyes are covered for protection. During
phototherapy, your child may be a little dehydrated so extra feeds may be needed.
If your doctor has advised sunbathing for the jaundiced baby, expose him to indirect sunlight because of not more than 20 minutes as baby skin is very tender and sunburn can occur effortlessly. Expose your child only to the morning sun (and indirectly) when there is less heat.
Remember to shield his eyes in the sun during sunbathing and turn him every 5 minutes. You may give your baby water in between milk feeds as dehydration may occur.
SEVERE JAUNDICE
In severe cases, in which the level is higher than 350 p.mol/1, jaundice may cause brain damage inside a baby [kernictems). This can lead to irreparable harm to his psychomotor functions, mental retardation as well as death. If you notice the typical symptoms of jaundice-yellow discolouration of the skin, palms and white from the eyes-but combined with nausea, vomiting, stomach pain and sometimes passing of dark-coloured urine and poor feeding because of severe lethargy,
bring your child to some doctor immediately.
Early treatment is essential and may save his life. Never attempt self-medication. In such cases, phototherapy alone is usually ineffective and a blood exchange
transfusion are usually necesary when the levels are extremely high.
G6PD DEFICIENCY
G6PD deficiency is one of the causes of jaundice. It is caused by a genetic linkage where the mother is really a carrier and the condition is manifested in her son. Approximately 50% of her offspring is affected if the mother is G6PD deficient. If your little one is G6PD deficient, you should keep in mind that as the condition can last for life, he can still lead an ordinary healthy lifestyle with the following precautions.
? Don't use mothballs on his clothes and beddings as they possibly can trigger an immediate breakdown of his red blood cells.
? Avoid giving him certain traditional Chinese herbs and fava beans (bian dou) as they can also trigger a rapid breakdown of his red blood cells.
? Do not attempt self-medication.
? Avoid certain medications if you are breastfeeding. Talk to your doctor to find out the types of medicines you
should avoid.
ABO INCOMPATIBILITY
This problem refers to the mother and also the baby's incompatible blood groups. If the mother is Blood Group 0 and also the baby is really a, B or AB, an issue from the mother's blood can go over the placenta and cause breaking down from the baby's blood cells. This applies to Rhesus incompatibility in which the mother is Rhesus negative and the baby is Rhesus Positive. In such instances, the red blood cells break up rapidly, resulting in jaundice. This normally appears within Twenty four hours but is rarely severe. In severely cases, blood exchange transfusions are needed.
