Neonatal Jaundice

Introduction

Neonatal Jaundice is a very common problem among all the new born baby. What jaundice means is yellow discoloration of skin and mucous membrance. Usually jaundice can detected easily on the skin and sclera of eyes. This yellow discoloration is due to excess of bilirubin in the blood which cannot break down in the baby due to immature liver.

Level for admission

Neonatal jaundice need to be detected and treated promptly. If the bilirubin go beyong the accepted level (normal is around 250-260 mcmol/l but also depend on age of baby) then the baby should be admitted to hospital.

Effect of bilirubin to baby

The most unwanted complication of jaundice is kernicterus, means bilirubin deposition in the baby’s brain. Of course, baby’s brain function will be permanently affected.

Causes

1.       Traditional medicine

Mother is consuming herbs that contain steroid during the breast feeding period. This steroid can pass to the baby causing jaundice

2.       Different blood group

Mother and child have different blood group. Antibody from mother can pass into baby’s body causing hemolysis.

3.       Cholestasis

Obstruction to the bile duct can cause persistent jaundice and ultrasound of the abdomen is needed.

                                     

Treatment options

1.       Avoidance of traditional medicine

2.       Phototherapy

With the help of the UV light from phototherapy, bilirubin can be broken down and excreted from the body via urine and feces

3.       Exchange transfusion

If the bilirubin go beyong critical level around 400+, then exchange transfusion is needed. What doctor do is to take out some portion of the blood and replace it with blood transfusion via the umbilical cord

Personal experience

My baby developed jaundice on D3 of life with bilirubin of 171 mcmol/l (slightly high) but did not need any treatment yet at that time. She was discharge well. During the follow up on her D7 of life, her bilirubin was 300mcmol/l and doctor recommend admission. She was admitted to Gleneagles Hospital Nursery Ward for phototherapy. First thing pediatrician asked is whether mother is taking any Chinese traditional medicine or not. You will definitely get the scolding from the doctor if your answer was yes.

After almost 1 day of phototherapy, the bilirubin level dropped to 178 mcmol/l and she was discharged home. The service in Gleneagles Hospital is excellent although it cost me around RM 500 for baby’s 1 day stay. My baby’s blood group is different from my wife. This can explain the jaundice. Some people believe that mother’s antibody entered baby’s body during labour thus  causing hemolysis (red cell break down) and jaundice.

After that, my baby jaundice was reduced and recovered. Please stop traditional medicine during jaundice period!!