Neonatal jaundice: What New Mothers or Pregnant women need to know

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Neonatal jaundice also known as Neonatal hyperbilirubinaemia is a condition in newborn’s which occur as a result of excessive bilirubin in the blood. It is characterised by the yellowing of the sclera( white part of the eye) and skin.

Immediate treatment plays a key role in the prevention of the adverse outcomes from severe Neonatal jaundice. Despite this condition being very common newborns worldwide, most people especially mothers and mothers to be do not have correct knowledge about the condition as most people have come across mostly give wrong information about the condition probably myths being passed down from generation to generation.

A study carried out in Nigeria among 189 expectant mothers attending the University of Benin Teaching Hospital(UBTH) in 2005, revealed that the mother’s knowledge about the main cause of Neonatal jaundice was gross deficient.

About 49.7 percent did not know the danger signs of Neonatal jaundice and 14.8 percent believed in the use of local remedy such as extract of unripe pawpaw for the treatment of the condition. Clinical experiences have shown that many babies arrive late in hospital in Nigeria with Jaundice.
Neonatal jaundice occur in most newborns and the hallmark of effective treatment is early intervention and appropriate therapy. Early postnatal discharge from hospital with the mother nor being able to identify the signs and symptims of jaundice could be one of the reasons for late presentation.

MISCONCEPTION’S ABOUT NEONATAL JAUNDICE
1. It is as a result of the mother’s diet during pregnancy: this is far from the truth as some people have the belief that if an expectant mother eats foods of yellow colour it could lead to jaundice probably due to some of the signs which include yellowish eye and skin.

2. Use of unripe pawpaw water as a form of treatment: sadly have experienced health workers prescribe this to mothers whose babies had the condition which was during my practical as as student and I dare not say a word because according to them I know nothing, though it was a primary health centre and there was no available doctor just the community health extension workers.

Am not trying to say community health workers are not competent enough just that majority of them do not have up to date knowledge about certain health issues probably because most local government do not organise on the job training for them.

Unripe pawpaw water is not a form of treatment for jaundice in newborn as a matter of fact the time you are wasting in giving your child that water the child’s bilirubin level is actually increasing and if this is not treated early it could lead to brain damage.
I belief there are other misconceptions but these are the only two am familiar with.
SIGNS AND SYMPTOMS OF NEONATAL JAUNDICE
* Yellowing of the white part of the eye
* Lack of appetite
* Excessive sleepiness
* Seizures
* High pitched crying
* Irritability
*Pale stool

TYPES OF JAUNDICE
There are various types of jaundice but the following are the most common types;

* Physiological jaundice: it is also referred to as normal jaundice and usually become evident in the second or third day. It is caused by the inability of the newborn’s immature liver to metabolize and excrete bilirubin.

* Breast feeding jaundice: this type is as a result of insufficient feeding or caloric deprivation. It has to do with feeding- related factors, how often the mother breastfeed and we’ll the baby suckle , this is why it is important for every expectant mother to know how proper way of breastfeeding so as to ensure the baby is getting adequate milk and not just ducking on air.

*Maternal-fetal blood group incompatibility( RH, ABO) : it is important for every body to have the knowledge of their blood group and Rhesus sign as these could have a grave effect on the health of a unborn child. To help understand ABO incompatibility, there are four blood type A, B, AB and O, each blood type as it’s own individual collection of chemicals on the blood cell surface known as antigens, so type A has A antigen, B has B antigen, AB had both antigens while O has no antigen. I different blood mix, an immune response occurs and the person will produce antibodies to arentigenttack the foreign blood antigen.
During pregnancy, the mother’s and the baby’s blood generally do not mix, oxygen, nutrients from food and everything the baby needs is diffused through the placental membrane.

However, circumstances can cause the blood to mic such as trauma, birth and sometimes they mix for unknown reasons, if the the antibodies could cross the placental membrane into the baby’s circulation, it may increase the destruction of red blood cells and this destruction increases the production of bilirubin hence jaundice in the baby.
Rhesus incompatibility occur when a mothers has a Rh+ blood and the baby is Rh-, the mothers blood will produce an auto-immune response that attacks the foetus or newborns blood cells as if they were bacteria. Blood incompatibility can be detected in early pregnancy if it’s nor detected , the newborn could develop severe jaundice which could lead to brain damage.

* jaundice of prematurity: newborns of 37 weeks or earlier or regarded as premature or pre-term babies, the incidence of Neonatal Jaundice is higher in premature babies because the liver is not fully developed which makes it difficult to excrete bilirubin effectively. To avoid complications, pre-term babies are usually treated even when their bilirubin level is lower than full term with normal jaundice.

* Pathological jaundice: mosteoporosis causes of jaundice outside those mentioned above are regarded as pathological jaundice. Features of pathological jaundice include the appearance of jaundice within 24 hours after birth and prolonged jaudice with underlying illness such as sepsis, rubella, liver problem e.t.c.

TREATMENTS METHODS FOR NEONATAL JAUNDICE
The severity of the jaundice will determine the treatment method which is why it is important to seek for immediate medical attention. Treatment methods include:
* Phototherapy
* Exchange blood transfusion
*Intravenous immunoglobin

EFFECTS OF NEONATAL JAUNDICE
When Neonatal jaundice is not treated early, the bilirubin level increases and it later damages the brain and this condition is referred to as KERNICTERUS, once this happen the effect has no cure, it is permanent the child will have to live with the effect for the result of his/ her lives. Some of the effect’s include;
* Cerebral palsy
* Hearing loss
*Learning difficulties
*Problem with normal eye movements
*Poor development of teeth
*Death

As a mother once you notice anything odd about your newborn while in the hospital or after being discharged please do not hesitate to seek immediate medical attention preferably see a pediatrician from a General or Teaching hospital, please do not give herbs or antibiotics or unripe pawpaw water when you notice any sign of jaundice in your newborn. Please visit the hospital immediately not chemist because as the bilirubin level in the child increases the chances that the newborns brain will be damaged also increases and I belief no mother will want their child’s brain be damaged. Please do not listen to anybody that tell you otherwise.

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