Jaundice In Newborns

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

Newborn jaundice is a condition marked by high levels of bilirubin in the blood. The increased bilirubin causes the infant's skin and whites of the eyes (sclera) to look yellow.

Jaundice can be explained using a proximate explanation as a yellowing of the skin and eyes due to excess bilirubin. Bilirubin is a product of the breakdown of haemoglobin. It is made water soluble in the liver before being excreted into bile. [6] So bilirubin appears to be a useless waste product. It is only by looking at the evolutionary explanation for it that we understand its true value. Bilirubin is an antioxidant that protects against oxidative damage that leads to aging. High bilirubin levels have similarly been associated with a lower rate of heart attacks. Haem is first converted to biliverdin, then a reaction catalysed by biliverdin reductase produces bilirubin. Dangerous oxygen radicals react with bilirubin, preventing cell death.

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

Defining premature birth is much more than just a denotative phrase. It is not just a preterm birth, or a baby born early. It is a life-changing event, and something that affects millions of people worldwide. The intense quiet room with heart monitors beeping, as parents see their baby and are devastated. Loved ones can not feed them or kiss them nor, can they not hold them or hug them. They do not get the same experience as others. Little miracles lay inside these cubes where multiple wires are help keeping them alive. A place where prayers happen, and where all hope for the best. Nobody knows the true pain and struggle behind a preterm birth and it needs to be discussed. Prematurity is a serious conflict; therefore, it needs more awareness as many families are facing this tough situation.

Once the infant is born, maternal antibodies are cut off and the neonate’s production of IgG rises. The maternal antibodies are metabolized faster than the infant’s production of immunoglobulin, which leaves the infant more vulnerable to infections.

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

     Some women choose not to breast-feed because they have heard the common myth that breast-feeding causes jaundice, or excess bilirubin in the skin that causes a baby to look yellow (Lim 70). This belief is unfounded. Breast-feeding is actually the best thing that you could do for a jaundice baby because colostrum, the rich fluid that comes in before your milk, actually acts as a laxative to help the baby pass meconium, a baby’s first bowel movement, which is high in bilirubin (Lim 70).

The patient population is the preterm babies that are less than 37 weeks’ and weight

Some of the progressive signs of respiratory distress exhibited by this infant after birth are; nasal flaring, grunting, coarse breath sounds, increase respiratory rate of 100 and irregular, acrocyanosis, his appearance of being pale, circumoral cyanosis, and him developing jaundice as a result of his increased work of breathing and hypoxia which causes an increase in erythropoietin to be released from the kidneys resulting in polycythemia as a result of low levels of oxygen in the body. Subsequently, as a result of an increase or red blood cell production the body will develop jaundice due to an increase in red blood cell breakdown which causes an increase of bilirubin in the blood to accumulate, therefore, causing jaundice to develop.

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

Premature newborns have an increased risk of complications because their bodies still have underdeveloped parts such as the lungs, digestive system, immune system, and skin. Thus, promoting oxygenation, nutrition, and fluid balance, maintaining thermal regulation, resuscitation and transferring the newborn to NICU unit will help the child to get better (Ricci el., 2017, pg. 887).

Max’s SBR level of 300mmol/L at 60 hours old requires phototherapy treatment according to the SAPPG hour specific bilirubin chart (Image 2) (SAMNCN 2010). Following the recommendation of the ISBAR, phototherapy using a bilibed is to be commenced on the early shift. Seeing as Max is otherwise well, it is appropriate for him to remain in the open bassinet with correct monitoring whilst receiving phototherapy treatment via a bilibed (Flinders Women & Children Division 2014; QMNCGP 2012). Important points to consider when caring for a baby receiving phototherapy treatment include: ensuring correct skin care – washing with water only, no oils or creams used on exposed skin, ensuring the neonate is naked aside from a nappy and eye protection pads to maximise skin exposure to the lights and ensuring adequate hydration by monitoring fluid intake, urine output and observing stool consistency (RPAHNC 2005; Maisels, J 2006). Max’s SBR should be rechecked according to local protocol but generally 6 hours after phototherapy was commenced to assess the effectiveness of the phototherapy (QMNCGP 2012). It is vital to ensure phototherapy lights are

There have been many changes throughout the years in healthcare. One of the many changes that affect us every day is oxygen toxicity in premature babies and the effects on their eyes. There is a fine line to walk when protecting the function of the brain and preserving vision. The risks have been a concern for healthcare providers for decades. Some people were born at 26 weeks in the early 60’s and suffers from severe retinopathy from over oxygenation. Between 1950 and the mid-1960’s many babies were blinded due to over oxygenation (Millenson, 2015).

Jeune syndrome is a rare inherited disease that has a significant impact on infants and small children. As a result of this disease infants with this condition usually experiences difficulty breathing, kidney abnormalities, and other life threatening issues. Antenatal examination is possible by ultrasound but specific diagnosis is difficult and seemingly impossible. Individuals are diagnosed at birth after careful observation of the limbs and chest area. Patients usually die from respiratory failure because of a very small chest and repeated respiratory infections (Phillips and Van Aalst 2008). There is not a lot that can be done for patients with Jeune syndrome because scientists are still in the process of obtaining knowledge about the initial cause and ways to prevent the mutation (Phillips and Van Aalst 2008). It is understood that because this is autosomal recessive disease, meaning both parents must be carriers.