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Opinions of Tuesday, 22 June 2021

Columnist: Regina Benneh

Infant jaundice: what public needs to know and do?

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Infant or neonatal jaundice, according to medical experts is a health condition, where a baby’s skin and the white part of the eyes appear yellowish and if not treated can gradually cause the death of an affected infant.

What is neonatal Jaundice?

Medical experts say it is a common condition in infants that affects over 50 per cent of all newborns, particularly in premature baby boys more often than girls.

It usually appears within the baby’s first week of life and give cause for alarm since in rare cases, untreated infant jaundice can lead to brain damage and even death.

Against this background, medical practitioners generally advised that parents must consciously look for jaundice in their new-born babies and report early to hospital for interventions.

It is thus recommended that babies must be tested for jaundice before being discharged from the hospital and also between three to five days after birth when bilirubin levels are believed to be at the highest.

Bilirubin by medical definition is a yellowish substance in a person’s blood and forms after red blood cells break down, and it travels through ones liver, gallbladder and digestive tract before being excreted.
Diagnosis

Jaundice could be diagnosed based on appearance alone, but the severity of it could be determined by measuring levels of bilirubin in the blood. If infant jaundice persists for more than two weeks, doctors might perform further blood and urine tests to check for underlying disorders.

Causes

The Sunyani Municipal Hospital (SMH) described the month of May as “Yellow Month” and set aside a week for awareness creation by educating the public about the disease and its negative impact on babies.

Explaining further the nature of the disease, a male health personnel of the SMH who spoke on condition of anonymity told the Ghana News Agency (GNA) during the week of awareness creation that neonatal jaundice is known to be excess bilirubin - a waste product produced when red blood cells are broken down.

He said before a baby is born, it has a different form of hemoglobin which breaks down rapidly. That according to him generated higher than normal levels of bilirubin that must be filtered out of the bloodstream by the liver and sent to the intestine for excretion.

However, because an under-developed liver could not filter the bilirubin as fast as it was being produced, that resulted to hyperbilirubinemia (an excess of bilirubin).

The health personnel mentioned other causes that included; insufficient breast milk intake resulting to inadequate quantities of bowel movement to remove bilirubin from body could result to such condition.

Infant jaundice in relation to breast-feeding is common in new born babies who are not fed well, perhaps because their mothers’ breastmilk might not have been flowing well. And its resultant effect is liver disease, sickle cell anemia, abnormality of the baby’s red blood cells, blocked bile duct or bowel, higher numbers of red blood cells-more common in smaller babies and twins, bacterial or viral infections.

Mothers’ Stories

Madam Ama Susuana, a mother of three recounts her experience to the GNA in Sunyani, saying her second born after birth was admitted because of infant jaundice and for almost about a week could not sleep. I was psychologically traumatised because whenever I saw a nurse coming I would quickly rise up, thinking the nurse was coming to me.

Really is a great traumatic experience if being a nursing mother “your baby is admitted because of neonatal jaundice”. It could be described as a situation of no hope, because “your heart beats whenever you hear your name being called by a nurse on duty, since you might think your baby on admission might have died and that the mention of your name would be followed by that bad news.

Mad. Susuana said because she could no longer bear the agony she went through during and after her second delivery, she refused for her third child to be admitted at the hospital on grounds of same disease.

She requested to be discharged for home treatment of the baby. The doctors obliged and thankfully by God’s grace the baby after a week recovered and by the next review the baby was declared jaundice-free.

Mrs Lucy Addai, a mother of four said in another interview that her last born had neonatal jaundice and was admitted for almost a week. She said having had a caesarian section (CS) during delivery and expected to go home to be more comfortable for her wounds to be healed, “I remained at the hospital with the child without even a good sleeping place”.

Mrs Addai suggested expectant mothers needed to be given pre-counseling at the antenatal clinics before delivery to psyche them about possible occurrence of such situations so that they could know how to adjust.

“If not, it becomes a dilemma after a painful experience of child birth for a mother to think that she is free, only for the unexpected to happen”, she stated.

Mrs. Addai suggested the need for special rooms to be provided for the mothers so that they could have proper rest and recover together with their babies, otherwise mothers who could not sustain the pains of CS, coupled with mosquito bites would have to be admitted after their babies had become cured.

Signs and Symptoms

The most pervasive signs and primary symptoms of infant jaundice are yellowish discolouration of the white of eyes and skin in newborn babies, excessive sleepiness and irritability. It could also include drowsiness, pale stools and inability to gain weight.

Treatment

According to health experts, if the infant had severe jaundice, they might need to be detained at the hospital after birth for treatment to lower levels of bilirubin in the bloodstream and in less severe cases, treatment might be done at home.

Treatment methods for neonatal jaundice include frequent breast feeding and in severe cases blood transfusion and phototherapy (light therapy) by light rays might be needed where the baby is put under a special light, covered by a plastic shield to filter out ultraviolet light. The light manipulates the structure of bilirubin molecules to be excreted.

Complications

Untreated jaundice may lead to complications such as permanent brain damage, seizure disorder, cerebral palsy and death.

Prevention

The best way to reduce possibility of the incidence of infant jaundice is to ensure babies are well-fed eight to 12 times a day for the first week of their lives.

In addition, parents, especially nursing mothers must carefully observe their babies within the first five days for symptoms such as yellowing of the skin and eyes and report to the hospital immediately for treatment if any of the symptoms is noticed.

It is observed that regular antenatal clinics visit by pregnant women for blood test such as glucose-6-phosphate dehydrogenase (G6PD), hepatitis, blood type and early initiation of breast feeding could help prevent neonatal jaundice.

But health experts are saying no to some views by a section of the public that sunlight helps to prevent neonatal jaundice.