By Catherine Egwuom
Dr Leo Odudu, Medical Director, Emel Hospital, Festac, Lagos, has urged parents to take newborns with signs of jaundice to hospitals promptly.
Odudu gave the advice on Friday in Lagos while speaking with the News Agency of Nigeria (NAN) on prevention, early detection, timely intervention and effective management of neonatal jaundice.
He described neonatal jaundice as yellowing occurring within the newborn period, from birth to 28 days, affecting about 40 to 50 per cent of newborns.
According to him, premature babies are more prone to jaundice than full-term babies.
“Neonatal jaundice is caused by excess bilirubin in the bloodstream. Bilirubin is a yellow pigment produced from the breakdown of red blood cells,” he said.
Odudu said red blood cells normally lived for about 120 days before being processed by the liver after they expired.
He said excess bilirubin could spill into the bloodstream, stain the eyes and skin, and affect the developing brain in severe cases.
The paediatrician listed premature babies among newborns with higher risk of developing jaundice.
He also listed babies with blood groups A or B positive, whose mothers were O positive, as being at risk.
Odudu said babies with Rhesus-positive blood, born to Rhesus-negative mothers, were also more vulnerable to jaundice.
He added that severely ill newborns, babies with G6PD deficiency and poorly fed babies were at increased risk.
Others, he said, included babies with congenital liver defects, Down syndrome and other chromosomal abnormalities.
Odudu advised mothers to check the white part of a baby’s eye, known as the sclera, for early signs of jaundice.
“That is where jaundice, or yellowness, appears first. It progresses from the head downward,” he said.
He said parents often mistook normal changes in newborn skin colour for jaundice.
Odudu explained that normal newborn jaundice, known as physiologic jaundice, resulted from an immature liver’s inability to process bilirubin adequately.
He said physiologic jaundice usually occurred after the first 48 hours of life, peaked around the fifth day and resolved afterward.
“Any jaundice appearing within the first 24 to 48 hours of life is pathological and commonly due to the reasons already listed,” he said.
Odudu advised mothers whose previous babies had jaundice to be vigilant during subsequent deliveries and inform their doctors.
He said parents should take babies to hospital immediately once jaundice was noticed.
“If pathological jaundice is allowed to progress untreated, it can cause severe and permanent damage to a child’s brain,” he said.
Odudu said untreated severe jaundice could lead to cerebral palsy, deafness, blindness and other neurological deficits.
He, however, said physiologic jaundice usually resolved without causing damage.
The medical director advised Rhesus-negative mothers who delivered Rhesus-positive babies to receive Rhogam injection to protect subsequent babies.
He said such mothers should also receive Rhogam injection after miscarriages.
Odudu urged mothers to breastfeed babies adequately to prevent dehydration-related jaundice, also known as starvation jaundice.
He also advised pregnant women to attend routine antenatal care and receive necessary treatment to prevent neonatal sepsis.
“Neonatal sepsis is a condition that can predispose babies to jaundice,” he said.
Odudu described adequate exclusive breastfeeding as essential to newborn health and prevention of jaundice caused by inadequate feeding.
He said breast milk substitutes should be commenced when mothers could not breastfeed immediately.
“What causes jaundice is inadequate feeding of whatever form,” he said.
Odudu said breast milk jaundice occurred in about one per cent of cases due to a factor in breast milk.
He described it as a mild condition that could be managed by temporarily discontinuing breastfeeding for two to three days.
He said babies could be fed formula during the period before resuming breastfeeding.
Odudu said diagnosis involved clinical observation by trained health workers and blood tests to measure bilirubin levels.
“The bilirubin level in the blood is measured and compared with the age of the baby,” he said.
He said treatment options ranged from adequate feeding and home observation for mild physiologic jaundice to phototherapy and exchange blood transfusion.
Odudu said phototherapy was used when jaundice levels became worrisome.
He said exchange blood transfusion was necessary in rapidly progressive jaundice to prevent brain damage, otherwise called bilirubin encephalopathy.
“Phototherapy is very effective. Newer machines with LED lights are very effective in treating neonatal jaundice,” he said.
Odudu said mild physiologic jaundice might not require treatment but should be diagnosed in hospital by healthcare professionals.
“It will be wrong for parents to sit at home and decide that jaundice requires no treatment,” he said.
He cautioned parents against misconceptions that yellow skin colour in babies was always normal.
Odudu said Ampiclox syrup was not a treatment for jaundice because jaundice was not an infection.
He also warned against the use of pawpaw water and other herbal concoctions, saying they did not cure jaundice and could cause toxicity.
The paediatrician said exposing babies to bright sunlight was not necessary for treating physiologic jaundice.
“Physiologic jaundice will resolve, sunlight or no sunlight. Exposure to sunlight can cause dehydration and other skin irritations,” he said. (NAN)(www.nannews.com)
==========
Edited by Vivian Ihechu