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Management of Neonatal Jaundice
Jaundice is really a yellow discoloration of the skin, the mucous membrane and the white from the eyes. All newborns possess a certain degree of this condition. Jaundice is a result of excessive serum bilirubin within the blood. Once he is born, a baby baby starts to use his lungs to breathe. Excessive red blood cells, present in large quantities in the foetal circulation that carry oxygen break up, releasing sub-products known as serum bilirubin,
which is usually disposed off by the liver and passes out through the bowels. Some babies are unable to handle such disposal, leading to jaundice. Premature and Asian infants have higher levels of serum bilirubin compared to their Caucasian counterparts. As a result, neonatal jaundice is very common in Singapore.
Neonatal jaundice becomes noticeable from the third day and peaks round the six day, gradually disappearing after Ten days. It's harmless unless the amount are high.
SOME CAUSES OF JAUNDICE In infants Jaundice in babies could be brought on by any of the following.
? Pre-maturity
? G6PD [glucose 6-phosphate dehydrogenase) deficiency, a
permanent condition where red blood cells break up too easily when exposed to certain trigger agents.
? Sepsis infection in which the baby becomes infected
? ABO incompatibility, a blood group incompatibility that's fairly infrequent but, if there are any, can cause rapid and severe jaundice in babies
? Physiologic jaundice
? Breastfeeding jaundice
? Breast milk jaundice - Both viral and bacterial infections can result in the introduction to red blood cells. Umbilical cord infection, septicaemia as well as pyelonephritis may also result in jaundice.
Management of JAUNDICE
Phototherapy is really a safe and effective method of treating mild jaundice. This treatment is administered as a special micro-blue wavelength light condensed and
manufactured especially for this purpose. It's emitted from the fluorescent light tube.
The principle behind the treatment would be that the light has the ability to break serum bilirubin [unconjugated bilirubin) down to conjugated bilirubin after which flush it out using the baby's stools. The treatment is painless.
Your baby remains naked aside from a diaper in order to maximize the area of contact with nowhere light. His eyes are covered for protection. During
phototherapy, your child can be a little dehydrated so extra feeds may be required.
In case 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 extremely tender and sunburn can happen very easily. Expose your baby simply to the morning sun (and indirectly) if you find less heat.
Remember to shield his eyes in the sun during sunbathing and turn him every five minutes. You might give your baby water in between milk feeds as dehydration may occur.
SEVERE JAUNDICE
In severe cases, where the level is greater than 350 p.mol/1, jaundice may cause brain damage in a baby [kernictems). This may lead to irreparable harm to his psychomotor functions, mental retardation as well as death. If you see the typical the signs 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 due to severe lethargy,
bring your child to a doctor immediately.
Early treatment methods are essential and could save his life. Never attempt self-medication. In such cases, phototherapy alone is generally ineffective and a blood exchange
transfusion may be required if the levels are too high.
G6PD DEFICIENCY
G6PD deficiency is one of the causes of jaundice. It's the result of a genetic linkage in which the mother is really a carrier and also the condition is manifested in her own son. Approximately 50% of her offspring is affected if the mother is G6PD deficient. If your child is G6PD deficient, you should remember that while the condition can last for life, he is able to still lead a normal healthy lifestyle using the following precautions.
? Do not use mothballs on his clothes and beddings as they possibly can trigger an immediate introduction to his red blood cells.
? Avoid giving him certain traditional Chinese herbs and fava beans (bian dou) as they possibly can also trigger a rapid introduction to his red blood cells.
? Don't attempt self-medication.
? Avoid certain medications if you are breastfeeding. Consult your doctor to find out the types of medicines you
should avoid.
ABO INCOMPATIBILITY
This problem refers back to the mother and also the baby's incompatible blood groups. If the mother is Blood Group 0 and the baby is really a, B or AB, an issue in the mother's blood can go over the placenta and cause wearing down of the baby's blood cells. This also pertains to Rhesus incompatibility where 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.
