YELLOW MEANS GET READY

-

 



I left the hospital with a heavy heart. I wasn’t sure if the baby would make it. The prognosis was poor. The baby’s mother and grandmother had been thoroughly counselled about the baby’s condition. This situation could have been averted with the right knowledge and early intervention. But here we were, wondering if the baby would survive.

The baby had been healthy at birth, so he and his mother were discharged. When they got home, the baby’s paternal grandmother who was helping to care for the baby started using palm kernel oil to dress the baby’s cord. The cord got infected, and the baby later became jaundiced. They didn’t notice that the baby’s eyes were turning yellow until he was yellow from head to sole and was very sick. He was not sucking anymore, there was little movement in the limbs. His breathing was very shallow. There were times he would stop breathing for some seconds and then restart. The cord stump was infected. He was in bad shape. Sadly, he didn’t make it.

What is newborn jaundice and which baby is at risk?

Newborn jaundice is when the eyes and skin of a baby become yellow within the first 28 days of life. This is caused by a build-up of a substance called bilirubin in the baby's blood. The risk of jaundice is increased if there is an infection as was the case with this baby. Babies who are born prematurely are also at an increased risk. About 8 out of 10 premature babies will develop jaundice. When the mother has blood group O or is RH negative, i.e. the blood group has a negative attached to it e.g. O negative, the risk is higher if the baby has a different blood group. Babies who have G6PD deficiency, birth injuries resulting in bleeding into a body part, and babies not getting enough feeds or breastmilk, are also at an increased risk of newborn jaundice. If there is a history of newborn jaundice in an older brother or sister, the risk goes up. Mothers with offensive vaginal discharge which is not treated before delivery also put their babies at risk of jaundice.


Why must you look out for jaundice in your baby?

When the jaundice is severe, it can affect the brain, a condition called kernicterus. This can lead to the death of the baby or lead to long-term complications such as cerebral palsy, learning disabilities, epilepsy, developmental delay, and hearing impairment.

How do you check for jaundice?

Jaundice usually starts from the eyes/face before it extends to the rest of the body. Some babies do not open their eyes often in the first week of life and some parents traditionally don't take babies out of the room in the first week, so it is easy to miss it when it first develops.

Take the baby into bright light 2 or 3 times a day to look for yellowing of the eyes or skin. Blanching the skin can also make the yellow more visible.

Look out for reduced activity, abnormal crying, convulsion, abnormal posture, or poor feeding. These are signs that the jaundice is getting worse and might have extended into the brain. Check the colour of the stool. If it is not yellowish but appears pale or clay coloured, it means there is a problem. Babies who develop jaundice within 24 hours of life would usually require hospital admission.


What to do when you detect jaundice.

Send the baby to a hospital where the level of bilirubin in the blood causing the jaundice can be checked and further treatment given.

What you must not do

Do not put breastmilk in the baby's eyes. It doesn’t cure jaundice. Instead, breastfeed the baby adequately, this may prevent jaundice and may help in clearing the jaundice.

Do not expose the baby to the sun. It can be harmful.

Do not give the baby glucose drinks. 

Do not put camphor balls in the baby’s clothes.

Do not bathe the baby with herbs or give the baby a herbal preparation to drink. These can lead to jaundice in babies with G6PD deficiency.

Do not use toothpaste, palm kernel oil, or substances not given to you at the hospital to care for your baby’s cord. The cord can get infected, and the baby can become jaundiced.

When you see yellow in your baby, it means get ready to take your baby to the hospital for assessment and treatment. If not, you must be getting ready to have a very sick baby who may die or develop long-term complications. While newborn jaundice may not always be preventable, early detection and early appropriate intervention can save the life and future of such a baby.

Dr (Med) Gloria Amponsah-Kodua

Paediatrician

Acknowledgement

Dr (Med) Akosua Omenaa Boateng

 

 

 

 

 

Comments

Post a Comment

Popular posts from this blog

PLAYING WITH FIRE

-
Image
  “Doctor Gloria, I have bad news for you this morning. I am afraid we lost the child we referred yesterday”. The paediatric nurse said. For a few seconds, I was speechless. When I finally found my voice, I asked, “How is the mother?”. “I am told she is devastated.” She answered. I had to say a silent prayer for the parents. To lose a child who had been so well to a preventable condition is one of the most difficult things to deal with in life. This child was admitted to the hospital I work in with burn wounds. When I saw how extensive the injury was, I asked that we quickly stabilise and refer her to a tertiary centre where she could have access to a specialised unit for burns and health professionals who could properly manage her. The problem with extensive burns is that on a continent that is still battling with lots of infections, the risk of dying is very high even when the best care is given. The skin provides a barrier that prevents harmful organisms from getting int...
Read more

BE THAT HAND

-
Image
  She would come for review with her 4-year-old son firmly strapped to her back. The boy was heavy but how could she allow him to walk beside her? He would be all over the place and they would get stares. She  couldn’t afford a wheelchair that could keep the child strapped and restrained. I wondered what the journey on the commercial vehicle was like. He had been diagnosed with Autism, Epilepsy and had symptoms of attention deficit hyperactivity disorder  (ADHD) . He was not speaking yet and had no friends. Not all his medications were covered by the national health insurance scheme, and some were costly. In a country where the few inclusive schools and rehabilitation centres are mostly found in the cities and are not free, the future looked gloomy for him. His mother didn’t have a stable job. She was the one caring for him, so it was not feasible for her to look for a well-paying job that would require her to be away from him. I remember speaking to the father of ...
Read more

WHY DOES MY BABY CRY A LOT, PASS MUCH GAS AND KEEP STRETCHING?

-
Image
  Many parents get worried when their babies cry excessively. Excessive crying in babies could be due to several things. For example, wet diapers, pain from an insect bite or injury, unwellness, hunger, thirst, etc. Sometimes, babies cry and pass out a lot of gas while stretching. They may even refuse breast milk. And parents are often left worried, not knowing what to do. These babies most likely have  infantile colic , a disturbance in the gastrointestinal tract or the gut. What causes infantile colic? The exact cause is largely unknown. Colonic fermentation, which is the breakdown of carbohydrates into fatty acids and other metabolites in the large intestine by anaerobic bacteria has been proposed as a cause. During this fermentation process, gases are produced. Excess gas in the infant's immature gut can cause much discomfort. Colic is also thought to be associated with excessive swallowing of air when the baby is feeding. Some studies also suggest that psychoso...
Read more