- As mothers tell their stories
Medical experts with specialty in infants care have highlighted the causes and symptoms of Jaundice, a common condition in new-borns and preterm babies, which affects one in two infants globally, and responsible for one in five neonatal admissions in Nigeria.
According to a Neonatologist at Children's Hospital in Boston, Massachusetts, U.S.A, Dr Anne Hansen, Jaundice refers literally to the yellow discoloration of the skin and eyes of babies, who have high bilirubin levels in their blood. Bilirubin is a yellow pigmented chemical that is released from red blood cells.
Likely factors that predispose new-borns to Jaundice according to the experts are: Normal Virginal delivery, inadequate supply of breast milk to infants in the first week of birth without infant formula; Glucose-6-phosphate dehydrogenase (G6PD) deficiency, increased red blood cell mass and the immaturity of the new-borns liver, etc.
Hansen, however explained the symptoms of Jaundice saying if a baby has mild jaundice, he/she might have no other symptom than the slightly yellow discoloration, which starts at the top of the baby's head and moves down from there. The earlier signs of Jaundice are seen on the scalp, the face and in the whites of the eyes. If the legs, soles of the feet and palms of hands are jaundiced, that probably means the baby has a high bilirubin level.
He therefore charged parents to visit the hospital if they see any of these signs in their new-borns and if they discover that the infants have very high bilirubin levels and are developing a brain injury, they will be lethargic, un-arousable and very sleepy. They may be agitated. They may have arching movements of their back. They may have a high-pitched cry or even seizures.
Dr Dion Alexandrou, a consultant paediatrician who specialises in caring for new-born babies at the Portland Hospital, says deficiency of G6PD could make a baby sleep more than a newborn should, it may seem lethargic and will not cry for feeds every three to four hours as a normal newborn will do.’ Even at this stage, if caught in time, phototherapy (which involves putting the baby under a fluorescent light) can help as it makes the bilirubin more soluble and therefore easier to flush out of the body.
He said if the baby is left untreated, lasting damage is caused to the brain. “Affected babies often lose their ability to move and they also develop uncontrollable movements of the body and hearing loss, once the damage is done, there is no way it can be reversed”, he asserted.
Alexandrou further urged parents to ensure that proper tests are conducted on their infants to establish the degree of the condition, because many professionals often rely on a visual inspection, but this is not enough to see how severe the jaundice is. ‘Jaundice can look worse than or not as bad as it really is to be sure, you need to do a blood test to check for the levels for bilirubin, and this is what the recent NICE guidelines recommend.
The stories published in Ghana agency stories revealed some 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”.
She suggested that expectant mothers should 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.
Addai further advocated the provision of special rooms 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.
Treatment
According to the 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.
