Hello Mums.
We are still talking about Jaundice in Newborns.
In Part 1 we defined Jaundice in the newborn, the mechanism, types and causes of Jaundice. We are concluding by looking at the management, myths, complications and prevention of jaundice where feasible in the Newborns
How do we treat Jaundice in the Newborn?
The most important thing FIRST; is to DETECT Jaundice when it is present in a newborn. Many babies have died from Jaundice because no one detected the Jaundice.
This is very important especially for those of you who deliver your newborns in hospitals without Paediatricians and doctors who specifically check out the baby before discharge. It is also important if you are discharged from the hospital before 48 – 72 hours of your baby’s life. This is because most jaundice develop after the 2 -3 days of life and most new mums don’t know HOW to detect Jaundice. Experienced Mums and Grandmas are better at it but they also miss it at times.
By the time your babies are really yellow or the white of the eyes is very yellow, the Jaundice is already high……Paediatricians we look for Jaundice in the SKIN in the white light or natural light. In fact we too can miss it just by relying on looking, in many places ROUTINE SCREENING for Jaundice is done at 24 Hours of life especially now that we have TRANSCUTANEOUS BILIRUBINOMETER with which we can detect jaundice without taking blood samples. We will go ahead to take blood if the tranbilirubinometer SB is high enough for us to worry.
This is the most VITAL INFORMATION….Should you leave the hospital before 24 -48 hours, Please go back in 2 days just for them to check the baby for jaundice. Sometimes the baby may have mild jaundice which is physiological but PLEASE never assume BEFORE THE SB is checked.
Many moms do tell me their babies have jaundice but the level was never checked even when the babies were being treated!!! I know because I manage such babies long-term complications from Jaundice as a Developmental Paediatrician. I want us to avoid this unnecessary loss of quality of life for those who survived, we actually lose some of them in severe cases. If you are in a Private Hospital cutting corner, please discharge your baby to a Govt Hospital or a good Private hospital which has a Paediatrician.
We do so many other blood tests to know the Cause of Jaundice. When your baby has Jaundice, Please we TAKE blood DAILY….YES WE BECOME VAMPIRES…..kindly oblige us, we are doing it for your baby’s own good. Trust us! Sometimes we take blood several times in a single day! Some of the tests we do include:
- Serum Bilirubin (SB) including total and direct (conjugated) levels.
- Full Blood Count (FBC) and miniESR.
- Mother’s Blood Group.
- Baby’s Blood Group.
- Direct Coomb’s Test.
- G-6-P-D screen.
- TORCHES screen.
- Abdominal USS.
- Liver function tests.
- Hepatitis B surface antigen.
- Sepsis work up.
We do not need to do all the tests but based on the information we have about the likely cause, we select the tests to do.
TREATMENT FOR JAUNDICE IN NEWBORN
All newborns with Jaundice should have the initial investigations and evaluation done.
For patients with unconjugated hyperbilirubinaemia, the SB level determines the treatment modalities.
- NO TREATMENT FOR PHYSIOLOGIC JAUNDICE
Neonates with physiologic jaundice based on the assessment above should not be admitted. They will be discharged home and review in 2days for repeat SB levels. Encourage mother to continue exclusive breastfeeding.
At follow-up in the Jaundice clinic (PLS ATTEND EVEN IF IT IS NAMING CEREMONY DAY, WE UNDERSTAND WE WONT KEEP YOU TOO LONG); if SB continues to drop, the baby should be discharged to the Neonatal Clinic.
A rise in SB level to pathologic jaundice requires admission and commencement of phototherapy immediately. - PHOTOTHERAPY
Pathological Jaundice requires commencement of phototherapy immediately. There are various options – blue light, white light, single, double etc
The Phototherapy helps convert toxic bilirubin to a form that is not toxic and can be removed safely by the Liver. Conjugated type of jaundice does not need phototherapy. - EXCHANGE BLOOD TRANSFUSION
When the SB level is 20mg/dl or above for term infants or 10 multiplied by the weight in kilograms for the preterm infant, the patient should have an Exchange Blood Transfusion (EBT). PLEASE COOPERATE…..Some parents reject blood transfusion which is a life saver…we are trying to remove the dangerous toxic bilirubin fast so that it does not cause brain damage which is our feared complication in Neonatal Jaundice. - OTHERS
Additional treatment to the above-mentioned and at times going on simultaneously depending on the cause include;
⦁ Antibiotics – if it is infections
⦁ Top-up blood transfusion if anaemia occurs
⦁ SURGERY – for Biliary atresia cause of jaundice
Complications of Jaundice in the Newborn
Why is Jaundice such a big issue in the Newborn that we have to talk about it?
This is because if jaundice is not properly managed in the newborns, it can cause what we call Kernicterus.
Kernicterus in simple term means brain damage from jaundice which can lead to other problems in the immediate (death) and future(disabilities). The brain damage can manifest as cerebral palsy, deafness, intellectual disability, teeth problems etc.
Outcome of Jaundice in Newborn
This is dependent on the underlying cause, but otherwise excellent with prompt diagnosis and treatment.
Biliary atresia requires surgery before 60 days of life for a better prognosis.
Most of our children in Nigeria suffer deaths and disabilities because of late detection of jaundice and presentation to health facilities. Additionally there are lot of myths and dangerous beliefs about Jaundice that are based on ignorance contributing to these sad outcomes in our country.
MYTHS AND JAUNDICE IN THE NEWBORN
- Yellow clothes and Jaundice – No cause from Yellow cloth but maybe the reflection of the cloth into the eyes or the fact that you may not pick jaundice easily with yellow wears, there is wisdom but it is not the cloth causing jaundice.
- Pawpaw water – so many believers in pawpaw water in Nigeria….please it has no basis for treatment of jaundice or prevention. As you can see from Part 1, there are many different causes of jaundice and not one treatment for all…..remember also the newborn organs kidneys and livers are not yet mature to handle these substances….pls don’t do it.
- Early Morning Sun/Sunlight – yes this can be used for treating jaundice…same principle as phototherapy but please let the doctor CHECK SB LEVEL FIRST AND BE SURE IT IS A LEVEL YOU CAN HANDLE AT HOME WITH EARLY MORNING SUN!!! Many delayed presentation by Dr Mums and Grandma doing jaundice treatment alone without SB level check have caused irreparable brain damage for newborns.
- GLUCOSE WATER and AMPICLOX.….These are not treatment of Jaundice in the Newborn o Mums….Ampiclox can only be prescribed if infection is confirmed…..It is not ROUTINE TREATMENT OR
PREVENTION OF JAUNDICE.
PREVENTION OF JAUNDICE IN THE NEWBORNS
Can Jaundice be prevented in the newborns? The answer is Yes!
There are some causes of Jaundice that can be prevented while for others, there is no way to prevent them but secondary prevention can be done by ensuring the jaundice is promptly detected and treated so as not to lead to the feared complication of kernicterus i.e. brain damage in the newborns.
Causes of Jaundice in the Newborns that can be prevented include:
- Rhesus Incompatibility
Jaundice due to Rhesus incompatibility can be prevented by Rhesus Negative Mums taking RHOGAM injection within 72 hours of delivery of a Rhesus positive baby or loss of a pregnancy either to abortion/miscarriages. This will help ensure the next baby will not develop Jaundice. - Prematurity
All steps and efforts to prevent preterm deliveries including good antenatal care will help prevent newborn jaundice secondary to prematurity. - Infections including the TORCHES
I hope you have learnt one thing or the other on Jaundice in the Newborns. I will like to know what you think about this topic. If you also have questions, you can send them in via comments or email askthepaediatricians@yahoo.com. I will be glad to answer your questions.
Join us as we wage the war against brain damage from jaundice due to ignorance. Tell a Mum about this important topic and share with your fellow Mums and Dads. Thank you for helping us fight disabilities from newborn jaundice.
Thank u doc for dis wanderful information nw i knw d cause of my son death bcs d doctors never told me wt killed him bt it was confom on tim dy stil discharge me,he leta develop anaemia wch dy said he need surgery bt dled til he died in ghp.But my problem nw is dat i took inn,in may an i miscarry d pregnancy again at six wks could dat hav anytin to do wt dis.Bcs am scad of pregnancy nw,wat do u tink doc
Hello Mary…sorry to hear about your challenges. Kindly register preferably at a Teaching Hospital Gynaecology clinic first even before you take in so you can be evaluated first to know what is the underlying cause of the recurrent miscarriages. You may want to check out a gynaecology blog of Dr Olajumoke Ogunro here
Dr please, what is the highest level of bilirubin in a neonate? What are the symptoms to be seen in a baby with the bilirubin level of 20.67mg/dl?
There is no highest level of bilirubin. However bilirubin level of 20mg/dl and above in a term baby is high and can lead to brain damage. Some of the early signs of such is baby refusing to suck, abnormal movements, convulsions, coma and death. Such jaundice must be treated with exchange blood transfusion to avoid this complication known as bilirubin encaphalopathy. Please read the part 1 and 2 of the article for details.
Thanks for this wonderful information ma
I discovered jaundice in my baby 7days after birth so I took him to d general hospital and I was asked to do some test and it’s written under the result(Uneonjugated hyperbilirubinemia)
The first doc that attended to me said the baby will be admitted later another doc came and check my baby and said it’s nothing to worry about and I was discharged..wen I got home grandma told me to place him on ampiclox and have been taking pawpaw water since den
My baby is 3weeks today and his eyes is already white and his skin is back to normal but wen I press his skin I still see traces of yellow
My question now is,how will I know that my baby is no more having jaundice?
To know your baby is no longer having jaundice, you should repeat the blood test for jaundice. Please do not use ampiclox or pawpaw water as they are not treatment of jaundice.
Thanks for teaching.. my baby have jaundice sb level 22.5 non 6th day of birth ND C6GPR is deficiency. Ebf was done for the jaundice. he is 4 weeks now I want to know more about the C6GPR and hope there will not be complications of jaundice so far we have do EBF because I always scared
G6PD deficiency I guess is what you want to ask. We will try and do an article about it. Alternatively you can just google G6PD deficiency or ask this question on our Facebook group
My daughter had jaundice for 2wks and 5days now, we were told at the hospital it’s mild should I be worried because the yellowing of the eyes have cleared up a bit but not completely . Do I need to take her back to the hospital?
What is the current level of the Jaundice? Jaundice lasting more than two weeks is not right!
Thank you, I have learned a lot, my 2nd baby had jaundice but 1st and 3rd baby didn’t, even though I observed light yellow eyes after the first vaccines bt cleared after 4days. I am so scared of jaundice.
Thank you for reading
Thank you Doc.. I wish I had seen this earlier.. My son had jaundice for two weeks.4 days after birth he was placed on a 24hrs phototherapy and after that he was given an injection for 2 days and then we were asked to do the third SB test. We did it and was told that it’s still high. But I could see his eyes clearing, d rashes with pus was also reducing. I didn’t have money for another phototherapy or injections so I took him home n started placing him under the sun and using paw paw water to bath him n also drink. By the third week I went back to the hospital and was told by the doctor that he was OK that we could go ahead with circumcision…but one thing I have observed since I gave birth to him is that his skin isn’t smooth n fresh as a newborn.. He’s having rashes on his skin that isn’t due to heat. Sometimes it seems like its clearing and before you know it another set comes out. And also he’s having discoloration on his face.. Small fair patches like eczema.. Pls Doc what could be the cause of this and possible solution.. Thanks
Kindly read the article about common skin conditions in babies here That has nothing to do with jaundice. How is your child doing in terms of development?
Thank you ma. I just read the article. He’s growing up well. He’s one month and eleven days old…I took him to Badore Health Center on Thursday evening because he started running temperature and the Doctor asked me to do a CBS and MP test. The results came out that he had a serious bacteria infection and small malaria.. I was asked to buy Orelox and paracetamol to be administered for 7days.. I was trying to get the doctors attention to the skin rash but he wasn’t even ready to look or explain much. He just said that I should get the drugs and if afterwards I still see the rashes I should come back..the skin conditions I read in the article is kind of different. His are not reddish, it comes out n makes his skin scaly and rough. I thought i could get a paediatrician or a doctor at the health center to help me examine him,but the doctor I met didn’t even touch my son, he just listened to my complains and said I should go for test..
You can see Paediatricians at General and Teaching Hospitals only not at the Health Centres
I have read your article and I blamed myself for using a private hospital for the delivery of my twins…. they both had jaundice and on the 11 day, they had circumcision and that day, one convulsed and rushed to the clinic and the doctor referred us to Fed Medic. Center. they were placed under the light and the other twin had severe jaundice and had blood transfusion/exchange……..now, this one with blood transfusion cannot control or hold his neck and head properly, he is restless at times, this is 7months now……he has been placed on Encephabol syrup + Vitamin B syrup and to undergoing Physiotherapy. please could you help with any other powerful syrup that could help in the cerebral palsy …………..email: abeldarius@yahoo.co.uk
Unfortunately Dare there is no powerful syrup to reverse Cerebral palsy. However with therapies, the child can make progress. Kindly read the articles on Special needs: Help I have a child with special needs (1) and Help Paed! I have a child with special needs (2).
IF you are in Lagos, you can come to the Benola Cerebral Palsy Initiative Family Forum on the 12th August 2017 at 10am at Hall 36 Lagos University Teaching Hospital to learn more.
Doc, we noticed he has jaundice 3 days after birth went to the hospital and was asked to run test it was at 10mg the doctor perscribed amplocx and asked us to go bck after 7. Day after d 2nd test there was no improvinment we went to fmc and did another test and subsequently booked an appointment with the peadtist as at today the test shows 8:75 mg but is eyes are still a bit yellowish and the doctor said he would be fine that there is no need for further test, please what do I watch out for?
Bw 2.6kg
Cw 4.3kg
Ebf
The level of jaundice is within the physiological level – that does not require any treatment.
Hello Dr. Does incompatibility in mother and baby’s blood group cause jaundice? I am O+ and my baby is B+. He had jaundice, although it was when I was abt to b discharged that the Dr. Detected this and we had to do s.b on that day BT we were discharged. I was discharged on Monday, came back on Thursday to collect the result and see the paed. The result from the sample said 17mg/bla bla bla. But the dr. Said he doesn’t look 17 again and wrote plenty test to do on that day. Blood group, ESR, HB, pcv, wbc, platelets count, and some other test. The result came out and I remember my baby’s pcv was 36. And the bilirubin was 12. We cldnt see the paed that day we saw a general practitioner who said d result was OK although his pcv is a bit low but it is still normal and said we shld see the paed an or day so we came back the following week Thursday and did anor SB and it was 10. That was when the paed discharged us. We didn’t do any phototherapy. From your write up u said if the SB is above 12, it is likely nt physiological. My baby’s own was 17 and dropped to 12 in 3days .I.e. Mon-thurs and in an or week dropped to 10.and d paed checked the sclera and discharged us. So my questions are, does difference in blood group cause jaundice? And my baby at 17 on first SB cld it have been a physiological or pathological thing? I did the pawpaw thing for two days out of fear of jaundice. But stopped and stuck to ebf. Reading your write up makes me understand d drs were doing the right thing with d repeated test. BT my people said, private hospital just want to make money. I just want a better understanding for future use.
Hi Mum!
Yes one of the causes of jaundice in newborns is BLOOD GROUP INCOMPATIBILITY!!! In your case it is the most likely cause as you are O positive and your baby is B positive so you have a setting of ABO incompatibility and couple with the low PCV of your baby, I am almost certain that was the cause of the jaundice in your baby. The SB of 17 is high and is definitely pathological and the cause here is the ABO blood group incompatibility. Seum Bilirubin is not a test you do and collect in 3 days!!! The test must be seen within 1 hour or so to know what to do. However since the SB has dropped, there is no need to worry any more. We just hope the jaundice has not caused any harm to the baby before it cleared.
Sorry doctor. So which means the kind of jaundice suffered by my baby can’t be prevented based on the ABO incompatibility. So invariably, in subsequent babies, I have to be on the look out esp. If I have anor B+ baby. I reread d article again… By harm I guess u mean the kernicterus. Well hopefully we pray he hasn’t gotten any harm. Thank you doctor. U have enlightened me more. I posted a reply just earlier and I read d article again to digest better
You are welcome Mariam….yes you just have to be on the look-out. So I will recommend that your baby is kept in the hospital for at least 72 hours. Most babies who will develop jaundice from ABO incompatibility will do so within the first 72 hours.
Once you do so, the jaundice can be detected as soon as possible and treatment commenced immediately and that will reduce the possibility of kernicterus or brain damage.
I am glad that your baby is fine! Well done Mum
Just reading your reply now. But what could be d cause of d low pcv in a new born? Is it the break down of d red blood cells? I remember I was anaemic in my 1st trimester but d dr. Increased my haematinics dose to boost the pcv and till birth it was OK. Dear Dr. In a future scenario if the baby’s s.b is more than 17 shld I just submit him to photo therapy? Instead of all d repeated test we were doing again and again. D reason y they said we shld come on Thursday was because dat day was d day the consultant will be around… I didn’t get to see d result and consultant till Thursday and there was public holiday dat week. What harm can the jaundice cause? My baby is 8months now though gave birth during the yuletide
1. There are many causes of low PCV in a newborn ranging from even the mother having low blood (anaemia) to baby bleeding (haemorrhagic disease of the newborn) to baby breaking down the blood cells too fast (haemolytic diseases of the newborn) and many others. It is the job of your doctor to investigate to know the specific cause in your baby!
2. For any SB that is above what is expected within physiological level, the child should be commenced on treatment immediately. The age at which we commence the treatment varies based on the age of the baby and the weight of the bay; it also differs between preterm babies and term babies. Your Paediatrician knows when to commence the treatment.
3. Repeated SB levels are necessary to know if the jaundice is going down or up as that may lead to mode of intervention. There is a level that we just have to exchange the baby’s blood immediately to avoid brain damage from jaundice (kernicterus). There are levels that are safe and we need not to worry.
4. Jaundice is not an emergency that should wait for a specific day for the Paediatric Consultant….the Paediatrician must see and take decision immediately!!! If the hospital does not have a full-time in-house Paediatrician, you should go to a hospital that has one. Most Teaching Hospitals have Paediatricians on duty 24 -7!!!
5. The result of jaundice must be seen immediately and addressed!
You mention RHOGAM injection can it be given before delivery or after delivery because doctor said it can be given before delivery or after delivery
After delivery within 72 hours. The doctors know what to do
I came back again to ask another question. Sorry for my many questions. It is all for clarity. Is it that as a general rule the ABO incompatibility will cause jaundice in new babies? Or there are exceptions? Like nt all baies will have jaundice as a result of blood group incompatibility. My hubby is B+ and I am O+. I am asking in case of future pregnancies.
It is not a rule! In such cases we say the mother and the baby has a setting for ABO blood group incompatibility. However it is not everyone who has that setting that will develop jaundice.
However, most will though some may have mild jaundice while others may have severe kind of jaundice. It is difficult to predict who will or will not have jaundice.
So the best thing to do in that instance is to expect the jaundice and to keep the baby at least for 72 hours to see if they develop jaundice or not so the treatment can be started immediately. Most babies that will develop jaundice from ABO incompatibility will do within the first 3 days.
if jaundice is detected and treatment commenced early, the child is unlikely to develop severe jaundice that will cause brain damage.
Mariam, you are free to always ask as many questions as you will like to. That is why I started Ask The Paediatricians. There is no need to apologize for the questions. I am very glad that you are learning and concerned about prevention of jaundice! That is the key
Good day doctors.my son had jaundice three days after birth.d result was 11mg.and he was placed under phototherapy..den d test was done again.and it was 7mg..hope its not harmful.
That is great! You do not have to worry at all…Actually sounds like physiological jaundice type that do not even require treatment to start with. There is no harm in getting the phototherapy though!
Thank you doctor for this article.I gave birth to my 1st baby without jaundice and my 2nd child has jaindice that we have to be readmitted after the 2nd test was carried out and I took rhogham injection for both birth within 72hours though they wrote due to rhesus incompatibility as I am negative rhesus what could have been the cause.Though we used light treatment and stay for 4days at SBU.
Great that you got the appropriate treatment.
Thank u ma.is it true that it is caused by untreated malaria during pregnancy.cos I had a terrible experience,thank God it ended well.my boy s SB was 9mg on the 4th day after delivery,I was discharged and was told to repeat the test a week later.wen it was repeated,it was 19.8.we were admitted immediately.I m glad dat they refused to circumcise him b4 then.top up blood transfusion was done immediately cos d navel cord was off already.phototherapy was resumed.after 4 days,the sb was 25.4.I was so afraid but we were still consistent with the phototherapy.but it reduced to 13 after 5 days,until it all disappeared completely at exactly 3weeks of life and we were discharged on a long dose(5days )of antibiotics as outpatient .I m happy my boy is bouncing at 5 mths now.Wat kind of jaundice was that?I was blamed by every body that I was the cause,that I didn’t take care of my malaria while I was pregnant.I need to hear from u
1. Jaundice is NOT CAUSED BY UNTREATED MALARIA.
2. ONE WEEK IS TOO LONG TO RECHECK SB LEVEL…It is usually 2 weeks after.
3. It is your doctors that can answer what the cause of the jaundice was based on the results of the tests they did.
It is not caused by Malaria…however I blamed the hospital for asking you to recheck in one week!!! That is too long. Let us hope that the jaundice has not caused any brain damage because that level of 25 is quite high and the baby should have had EXCHANGED BLOOD TRANSFUSION not Top-up tranfusion.
Since your baby is fine, I rejoice with you. Next time, go to hospital that has a Paediatrician on ground always.
Thanks for the enlightenment Ma..am a first time mum, three days after my baby was born, it was discovered that she had jaundice and after d SB level was checked it was 27 which was on d very high side and she was immediately placed under photo light and also blood transfusion was also carried out. But d first two days of birth, I kept asking d nurses if my baby had jaundice, they always tell me no, not until it was discovered on d third day and was high.. We’re at d hospital for 13 days when d SB came down to 3 and we’re finally discharge.. I want to ask y it was that high at first and also her PCV is low, at first it was 34, then it came down to 27, she was given folic acid and iron syrup, but she doesn’t like taking d iron syrup but takes d folic acid very well. And I heard that its d iron syrup that she really need. At last month check up when we went for her 10 weeks immunization, it came up to 29, which is still low…pls Ma, what could be d cause of d low PCV and what else can I give her since she refuses to take d iron syrup so that d PCV will be increase.
The story sounds like a baby who had Haemolytic disease of the newborn with severe jaundice. What is your Blood Group and what is the Blood Group of your baby? The commonest cause of such very high jaundice at birth with low blood levels (anaemia) is usually ABO or Rhesus Blood Group incompatibility (Haemolytic disease of newborns) or severe infections that cause the baby to break down the red blood cells rapidly. I am fairly sure that jaundice has been present from Day 1 but it was not picked up. Jaundice rarely rises to 27 on the day it started. I hope your baby is fine now? Please discuss with the Paediatricians about other iron preparation the baby can take.
Thanks doc, I really appreciate this write-up on jaundice. Please I believe if this jaundice information is given at antenatal clinics,it will reduce the level of ignorance by mothers thereby reducing it occurrence. Thanks for clearing the myths about jaundice being also caused by untreated malaria. My twin boy had mild Jaundice at birth. But we were discharged and asked to return after two days for check up. At the check up day, the sb test was done it was 13. He was immediately admitted and put on double blue light the first day and second day one blue light and the third day we were discharged without drugs. But as we were on our way out, a mild drama ensued. One of the nurses chipped in that the photo machine was not working. We hurriedly left the hospital to another one. At the new hospital, another sb test was carried out and the paediatrician cleared us of jaundice.
My question is
1. My son didn’t crawl but he sat at same time like his sister.
2. He didn’t get up and walk unassisted until 1.8months. But he walked when you stand him up before he finally got up on his own at 1.8months
3. He’s teething seems to be delayed.His molars are just beginning to come out at 3yrs 3months. He does not chew his foods or anything. He swallows them with the aid of water.
Please doc, hope these does not in any way imply any underling problems.
Also is there need for any therapy on children born with jaundice so as to forestall any disability from developing.
Thanks as you assist us with life changing advices.
I think your son has some developmental delay and I think it may be related to the jaundice or the fact that he is a twin. Were they born preterm? We may need to adjust for prematurity. The way to prevent disability from jaundice is to diagnose and treat it early. if jaundice is high, exchange blood transfusions should be done
Good evening Doctor. Thanks for this writeup on jaundice. I am a mum of 3 but my first 2 kids didn’t have jaundice until I had my 3rd baby last week Wednesday through elective CS at 38 weeks. We were discharged by the pediatrician on Saturday and on Sunday, a relative that observed my baby discovered she has jaundice. We came to the clinic on Monday and SB test was carried out and it was 13.6mg, immediately she was placed on phototherapy and this Wednesday morning another test was carried out and it was 12.8mg. The pediatrician asked us to still continue phototherapy till tomorrow when another test will be carried out because according to her, she wants the reading to be below 12mg before discharging us. My questions are
1. Is thus physiological or pathological type of jaundice?
2. What is the possibility of it increasing after discharge?
3. At what reading is it safe to stop the phototherapy so it doesn’t come back or increase?
Thanks for your response ma
1. No…it is not physiological jaundice if it is above 12 at any time
2. Jaundice can rebound depending on the cause, that is why your doctor will ask you to come for a follow up check after 48 hours of discharge
3. The doctor treating your child knows when to stop phototherapy once it is not increasing and less than the level for treatment for age, most paediatricians will discharge….it has to be less than 12
Thank you doctor for this article.I gave birth to my 1st baby without jaundice and my 2nd child has jaindice that we have to be readmitted after the 2nd test was carried out and I took rhogham injection for both birth within 72hours though they wrote due to rhesus incompatibility as I am negative rhesus what could have been the cause.Though we used light treatment and stay for 4days at SBU.
Glad that your babies are okay and you got your Rhogam. All the best.
Thanks doc, they were born at 37 weeks through an emergency C-section because of hbp. Weighed 2.8 while the sister weighed 2.7. Let me believe it’s due to him being a twin.
I appreciate your response.
No….twins gestation does not cause jaundice and they are term babies with normal birth weight. You need to confirm from the doctors who managed the baby the cause of the jaundice based on the tests they did.
Good day Dr.,
Please ma, Is there any way to prevent jaundice during pregnancy or any kind of fruit someone can take? Thank you and God bless you ma.
No!
There are certain jaundice causes that are preventable but most of the causes are not preventable during pregnancy.
Kindly read again the concluding part of the article above where I wrote about prevention of jaundice.
More often than not, early detection and prompt treatment is the way to prevent severe jaundice and its attendant complications.
There are no special fruits required to prevent jaundice.
Good afternoon Ma,
Please ma advice me on when to take rhogam during pregnancy, because I am a rhesus negative mun and I lost my first baby boy because I have no Idea of the result on newborn I was just told to do antibody titre test and the test came out saying no visible bla bla bla and the doctor I met on visitation said it means no sensitization yet and asked me if that pregnancy was my first time and I said yes and He said the doctor that told me to run a test wouldn’t have told me to do so since it was my first pregnancy and first pregnancy with rhesus negative is always save that what I should do is to get the rhogam ready to be administered after delivery to prevent subsequent sensitization, which I did. After delivery the baby started running temperature and one of patients detected that my baby has jaundice but she is not sure that I should ask the doctor and when I asked the doctor said is not true and discharged on the 3rd day, as day passes the baby was diminishing still went to the hospital they didn’t detect it, as day passes He Colour was changing to yellow and am with my mum and other elderly ones they couldn’t detect it until the baby died on his 21st day old no one detected the cause. But with social media I have come to know the cause. Secondly I have had three consecutive miscarriages and I took the Rhogam as said. Ma my question is can the rhogam be taking immediately the pregnancy enters second trimester to prevent the sentization that leads to still birth and jaundice, thanks.
Hi Gift! I am so sorry for your losses.
First, such a woman like yourself should be managed in a Teaching Hospital by Specialists – Obstetrician and The Paediatricians should also be the one seeing the baby!
If you have been sensitized, then you may need to get Rhogam even before pregnancy. However, if not usually Rhogam is given after delivery of Rhesus positive babies to prevent the next baby from having rhesus haemolytic disease!
I really do appreciate this write up. My own case is kind of serious. My baby was born with jaundice and was admitted immediately, he was transfused twice the day he was born and 3days later. A consultant saw him on the 5th day and asked us to go for scan, after the scan he said it was bilary artesia and reffered is to another hospital where the surgery is to be done. On getting there they repeated the same scan over and over again and even suggested we conduct the scan elsewhere and it was ruled out that it wasn’t bilary artesia. We have done all sort of test including the TORCHES test but everything seems fine. The jaundice level keeps going up and down, the last test we did was on the 19/12/2017 and the bilirubin was over 900 and the conjugated was 613. The doctors asked us to go for a scan, Hepatobilary scan and we have been booked since September but still the re-agent is not available and they are the only hospital that conduct such scan here and my son is over 3month now with a high level of jaundice. Ma I don’t know what to think again as I get scared everyday whenever I see him. He’s my first child and I can’t stand seeing him like this. He was given just zinnat, folic acid and abidec while he was being discharged in September and no other drugs has been given to us since. All we do is test today test tomorrow. He weighed 2.8 at birth and currently he’s 4.5, I feel his growth is slow. Help me please
You should see a Paediatric Gastroenterologist preferably at LUTH for further assistance. It is important to rule out the Biliary atresia.
Ma,my husbands Rhesus is B+ and I am B-.all along I have always thought I was B+ from my previous test in school.even where I registered for antenetal I was tested B+ not until I changed hospital to general when I am already 32weeks gone then another test carried out shows I am B- with confirmation from two different labs.my question now is what is the implication on my expected baby.I am presently 38w5days.
You should be given Rhogam after the delivery if your baby is Rhesus negative!
How I wished I had known this before now; I lost my second baby to jaundice. The jaundice was discovered on the third day after his birth and we took him to a Catholic hospital. He was placed on oxygen was drip as he was running temperature; I was told that they had to bring down the temperature before he could be placed under the photo therapy but unfortunately, he gave up about 12 hrs after. The result of his SB did not come out in time and the jaundice was fast spreading. In fact, I was told that it had already damaged his brain as at the time he gave up. MA, I want to know if jaundice could kill that fast because, he came out healthy and strong and he was taken to d hospital d day the jaundice was detected. My husband and I are both O+ so, it wasn’t the rhesus factor.
Hi Ayo….so sorry for your loss. It looks like your baby’s jaundice is due to infection (neonatal sepsis) since the baby is also having high fever as well. Yes very high jaundice can kill very fast as well. All the best.
Great job, Dr. I gave birth to my second son in a private university medical center. I’m O negative while my husband is A positive. I took rhogam after giving birth to my first son, he is O positive. After giving birth to my second son, the family health consultant said we would be discharged on the second day. When he came to discharge us, he noticed my baby had jaundice, he then placed him on phototherapy. By the third day, the Dr on night duty said the hospital can no longer handle it and therefore referred us to FMC, Abeokuta. On getting there, they did blood transfusion, 60mls, but the bilirubin level was still high, 32. They immediately carried out EBT. Post EBT test shows SB=2.2. Resident Drs went on strike and we were referred to any hospital of our choice to continue intravenous antibiotics treatment. We were discharged after five days with PCV=30 and SB=8. Fortunately, the hospital have a visiting pediatrician from FMC,Abeokuta. Two weeks later, I realized he was getting pale and took him back to the hospital. Pcv test was done and pcv was found to be 18, SB was normal. Blood transfusion was carried out immediately, 70mls. Test was done again and Pcv was 30. They then transfused 30mls of blood. Pediatrician asked if I’m putting camphor, naphthalene balls, in his clothes and I said no. I was asked to discontinue vitamin C drops. Lest I forget, my sister made cream from Shea butter, camphor etc for him. She said it protects against skin diseases. Pediatrician said I should stop using the cream that he’s suspecting G6pd deficiency. Test has not been carried out to confirm that. To God be all the glory, my son is 6 months old, doing great and very active. (saw the paediatrician few weeks ago). I don’t joke with him or his brother. If I notice anything, be it sneezing, cough, rashes, etc, straight to the hospital. Many people said I’m getting too anxious about them, but I don’t care. Cause of the neonatal jaundice, still unknown.
Thank you for the feedback Tolu! The truth is sometimes we do not know the cause of jaundice. There are other rarer blood groups that we do not test routinely in babies apart from ABO and Rhesus factor that can cause jaundice as well.
My son was born at 37 weeks, five days. Birth weight was 2.8 kg. I was on 5 mg folic acid plus vitamin B12 from three months before his pregnancy. I had seizure and was placed on carbamazepine(Tegretol 200mg CR) to avoid seizure recurrence before and during pregnancy. The folic acid was to nullify the side effects of the carbamazepine, e.g spina bifidia. To God be the glory! No effect on baby!
Congratulations Temitope! That’s great!
My blood group is O+ and my son is B+.
I was delivered of him via C/S at 37 wks plus 4 days.
On the 2nd day of birth, I noticed the jaundice n a paediatrician attention was drawn who checked him n requested for SB Which turned out to be 450 umol/l.
EBT was done immediately and post EBT SB reduced to 218 umol/ l
Few days after a repeat SB done was 388, subsequent SBs..,… 343, 248 and 218 after 2wks hospital admission.
All through dis period, d baby was on constant dly phototherapy. We wr discharged home on d 14th day of birth.
My baby is always squeezing n arching his chest n neck, always stretching d body.
Pls Doctor, I hope DAT does not mean any problem.
My baby sucks very well. In fact, he is always crying for food. I hv to start him on infant formula since it seems the breast milk is not enough for him.
Pls I need ur advise Doctor.
Mela, I am not sure what the question is here. I will rather you see your paediatricians about the squeezing and stretching to know if it is something to worry about or not. If he is sucking well, there is no need to add formula. Not all the crying in babies translate to hunger. It could be colic or just attention the baby needs. Definitely, your baby should be followed up by the Paediatricians in view of the jaundice he had.
Good day Dr,
4 days after i was discharged, i noticed my baby’s eyes were creamy. I guessed it was jaundice n rushed back. A test was run on my baby. D doctor said it is too mild n i should put her under d early morning sun. But here in abuja, it has been cloudy and there is no sun. Pls, what oda measures can i take cos i am scared that it may worsen. Tank u.
Just read this now, well done Doctor. Please I delivered my baby about a month ago and was discharged d following day .All d health workers were on strike as at then leaving only d doctors with d work. As a result, der was no peadiatrtian to attend to my baby,guess d doctors were overwhelmed with work. I noticed his eyes balls weren’t clear so I placed him in early morning sun for some days as adviced by my SIL and d eyeballs are clear now. But I’m kind of scared after going through dis article. My question is can my baby still be tested for jaundice – he’s one month and 2 days old today. He feeds well and seems to be developing well too, his birth weight was 3.4kg and was delivered at 40 weeks. I’m just worried. Thanks ma’am.
You should have gone to a Private hospital when you have concerns. It is too late to test for jaundice; not that the child can not be tested but it makes no difference. Let us just hope your baby is fine. If you observe any developmental delay (eg no neck control at 4 months), please see the Paediatricians immediately but I pray the baby will be fine. All the best.
Hi Dr. I had my daughter on 15/6/18 and her jaundice was detected 3 days later at 12. she was put under light for 2 days which made it dropped to 10 so we were discharged while we were told it’s physiological. We went back 2 days after discharge to check the level and it had gone back up to 12. Then we went back 2 days later, it had dropped again to 9.8. We went back 2 days later it was at 12 again and then we went back this past Thursday and it had dropped again to 10.1.
The Dr assured me that it’s physiological and her skin isn’t yellow and her eyes are almost white so I shouldn’t be worried and fixed our next appointment on the 12/07/18 which will make her 27 days by then
My question is, is it not too far and should I be worried about the fluctuation tho she feeds well on EBF and sleeps well too.
Hi Mama Zoe….the fluctuation in the levels of the jaundice could either be due to lab errors or breastmilk jaundice. However any level not exceeding 12 is still physiological jaundice and nothing to worry about. It is very unlikely to go to any level that will be of concerns; such levels are usually
reached in the first week of the baby’s life. Was it conjugated or unconjugated jaundice (the direct part of the serum bilirubin). Don’t worry….
Good morning Dr Gbemi. I delivered on the 21/8/18 and the sb of my son read 9.5. He was placed on phototherapy and the next day the sb rate increased to 11.1. The third day to 11.5 and the forth day 13. This has got me worried as am concerned about what might be wrong. Thank you.
Hi Funmi….It is normal for jaundice to go up first before coming dowm. Those levels are not worrisome to me. It is also important that your doctors check that the phototherapy lamps are working optimally sometimes they need to be changed after a couple of months but I will not worry and will only monitor the baby. Jaundice depending on the cause may rise and peak first before coming down and rate of rise depends on the cause of the jaundice. It may rise despite treatment as well. Just let the paediatrician keep monitoring. All the best.
Good day mum, thank you for your teachings ma, I’ve learnt a lot. My question is on jaundice. My first and my second baby had jaundice at birth. I’ve read on the prevention of jaundice in the article but I’m still lost and would need more clarifications ma. I’m even scared to conceive again because of jaundice. I don’t know what can be the cause though the jaundice of my children cleared before the 8th day. I am A+ and my husband is A-. I had my children two weeks before the EDD. I also had infections during pregnancy. Please ma I need your advice on what can be done to prevent subsequent occurrence. Thank you ma
I have answered this alrady; guess it is a repeat. Find out the specific cause in your babies from your doctors to know if they are preventable or not. Not all jaundice are preventable but early detection helps to prevent it from progressing to severe jaundice that can cause brain damage.
Thanks so much ma for the enlightment ma, my 3rd baby was born 39weeks 5days. I noticed the yellow colouration in his eyes few days after. But thought it would clear and there would be noting to worry about cos my 2nd baby had it too few days after delivery and I was told it’s mild and it did cleared. Was told then that maybe it’s due to the fact that am O+ and his dad is B+.
Now I took my baby back to the hospital on day 8 after birth. Bilirubin test was done (total bilirubin 222, congugated 14). The doctor sent us back that there’s noting to worry about, that we should do the early morning sun therapy for him. To bring him back on day 10 for a repeated test, the test was done on day 10 ( total bilirubin 235, congugated 24). We were admitted and phototherapy was started immediately.
But am worried, and hoping no damage has been done!
I don’t think so…Just continue with the management your doctors have started
Good day ma,I just came across this article now.I gave birth to my son in a private hospital 4th may and I was the one that noticed my son’s eyes were yellow.So the nurses said I should by ZINAT I brought it and gave my son,also gave him paw paw water and put him under the son it cleared.My concern now is that I did not do any test and my son is 3 month,I am very scared hearing of this brain damage.Please what can be done ma.
Secondly,my 1st son developed well but he is 2years and 7month he has not started talking, please I don’t have a pediatrician that I can take him too,am so confused.
Oh my goodness; you must have given birth in a substandard hospital with auxillary nurses. If your baby is otherwise fine, there is no need to worry. However if you have concerns; please see a Paediatrician at the closest teaching hospital to you. Virtually all general and teaching hospitals have paediatricians. As regards your son, you should see a speech therapist as well and a developmental paediatrician. As advised, try the government hospitals closest to you. If you ask on our Facebook group with your specific location (region or state); we will be able to guide you appropriately.
Good day mum, thank you for your teachings ma, I’ve learnt a lot. My question is on jaundice. My first and my second baby had jaundice at birth. I’ve read on the prevention of jaundice in the article but I’m still lost and would need more clarifications ma. I’m even scared to conceive again because of jaundice. I don’t know what can be the cause though the jaundice of my children cleared before the 8th day. I am A+ and my husband is A-. I had my children two weeks before the EDD. I also had infections during pregnancy. Please ma I need your advice on what can be done to prevent subsequent occurrence. Also ma, i discovered they usyally have very high temperature after birth before the jaundice is finally detected. Thank you ma and God bless you for all the great work you’ve been doing. May God reward you abundantly.
Hi Yemi…not all jaundice are preventable. It depends on the specific cause in your babies which sounds like infection but I think the Paediatricians who managed your babies will be in the best position to tell you why your babies have jaundice and if it is the preventable ones or not. There is no reason why you should be having infections each time before delivery. Please discuss these concerns with your Paediatricians and Gynaecologists. All the best.
Hi Doc. My little nephew just had LFT with these results; direct bilirubin: 7.8, total: 9.8, AST: 92, ALT: 94, alanin phosphatase 336. He is 19 days old. He’s still having slight discoloration in the eyes. Should we continue with the early morning Sun?
Why did he have LFT done? You should take the lab tests report to the doctor who requested the test for interpretation in the clinical context. The child does not need any early morning sun in the first place based on the type of jaundice he has. He should see a Paediatrician if one has not been seen before.
what about mothers that are 0-that was not given rogam after birth what is the way to prevent jaundice for the next baby
They can still get the Rhogam or their doctors need to monitor their babies very closely during pregnancy and be ready to intervene after delivery promptly if necessary
Good day MA, my son had jaundice at birth Buh we detected after one week and we took him to the hospital the doc said he needs to undergo blood transfusion immediately (EBT) which we did .his 4months 2weeks old now but am still worried don’t know if he is OK now. Though the doc said his fine . But pls ma how will I know if he is OK that it has not entered the brain before the EBT cos I heard children that undergo EBT usually have brain damage… Thanks so much MA.
Hi Jumai…not all cchildren with EBT has brain damage it depends on when the EBT was done. If done promptly, the child would be fine!
MA, my baby had jaundice at birth we detected when he was one week we took him to the hospital and the doc said he needs blood transfusion immediately, which we did after the EBT he still undergo phototerapy. He is 4months two weeks today the doc said his OK but am still worried coz I heard most baby that undergo EBT are not normal.
Hi Jumai…You don’t have to worry. I am sure the doctor will follow up your baby’s development. The EBT if done at the right time will prevent the complications you are worried about. Those who developed disabilities, it was due to late presentation and EBT was done after the damage already happened!
Gud pm Dr my baby was born at 32 weeks,birth weight was 1.85, he was given birth to on Saturday on Monday morning jaundice was detected 8.8 he was placed on blue light for 24 hours,another test was done and it reduces to 6.2,after 2days we did another test and it was still 6.2 baby we be a month old by July 11 current weight 2.5,feed both on breast milk and formula,pls Dr I just want to know what else to do he hasn’t taken BCG and circumsision
You should go for immunization. Your baby should be under regular follow up of a Paediatrician please. This is extremely important for all preterm babies to be followed up. You can get the material for our Preterm babies.
You can always post questions that require immediate answers on our Facebook group
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Hello Doctor, weldone, 8days after birth my baby SB level was 15.4 and he was admitted immediately, 3days later we where discharged with a 10.3, we where asked to come for checkup 2days later and it came out 11.1, after one week it was 9.6 then the pediatrician said we should go and make sure I breastfeed him very well, when I asked her if we should come back for another test she said no need, after reading this post am very worried, although his eyes are now clear, should I go back for another test?
No, the jaundice has resolved already. I am not sure what you read that is making you worried. Your child was treated and the jaundice has gone below to levels for no worries. So please do not worry!
My 16 months old son had neonatal jaundice and only babbles now. Not yet talking, though seems to hear well. He loves to dance to music, not necessarily from radio, that’s even when any member of the family is singing. Has met all developmental milestones for his age except talking. He understands instructions like ‘give me 5’, ‘give mummy a kiss’, ‘it’s hot’.
EBT was done when he was 4 days old because of the neonatal jaundice and blood transfusion when he was 2 months because he had pcv of 18%.
He sat at 6 months, crawled at 7 months and started walking at exactly 9 months 2 weeks.
The pediatrician said he’ll refer us for audiometry but as we were about to leave his office, I said ‘give mummy a kiss’ and he responded by making a kiss sound with his mouth. He promised to send us details about audiometry and yet to respond to my messages, guess he wants to give him time.
Sorry for the long post. I’m just an anxious mother.
I am greatly worried. Do I need to see another pediatrician?
P. S: The only thing I’ve heard him say apart from ‘mama’, ‘dada’ and ‘baba baba’ is the name of a girl in his creche ‘Darasola’ (not very clear like an adult but he says it especially when she is mentioned).
I understand your anxiety. You can do the hearing test and see a Speech and Language Therapist for further evaluation. He may just be mild delay in speech but it is okay to start the intervention as advised by your Paediatrician.
Hello ma, I am 32 weeks gone and my mum wants me to take UNRIPE Pawpaw water to prevent jaundice??is it possible to prevent jaundice before childbirth??
Hi Omoshalewa. It is not possible for unripe pawpaw to prevent jaundice either before or after delivery. The only jaundice that could easily be prevented are those due to Rhesus incompatibility. Mothers who are Rhesus negative should after delivery of a Rhesus positive baby take the Rhogam injection. Kindly read the two articles for more information. All the best with your baby!
Good evening Ma. Please still on the Juandice. Please my son is 8day already. And I Juandice was notice on day 3of life with 173 level was placed on phototherapy and we are being discharged with 70 level of it.but the yellow eye have not totally cleared from him. Please advise
The levels are not so high and nothing to worry about. The eyes will clear very soon so please do not worry!
Hello ma. My baby was jaundiced at 3 days the value was total was 9.6, direct 2.0. Baby has g6PD deficiency. Was placed on photography, yet d value peaked at 13.7 before it began to crash. Eventually discharged after 12 days of photography direct 1.4, total 9.6. It been 2 days at home, i went for SB test on my own for the baby, value was total 11.0, direct 0.3. Am scared, i asked d lab people for explanation, buh was told its noting to worry about because theirs its a diff lab from the one the hospital is using so i cant compare the results of 2 diff labs.my next appointment is in 2 days. Am scared
Hi Ifedayo…that can happen at times but then the level is not worrisome at all as long as it does not rise to levels above 12mg/dl. I will not worry.You can just check again but no need to worry but please also AVOID all the trigger agents that can lead to haemolysis in G6PD deficiency. I hope you were given a list at the hospital? The most common agent is naphthalene or moth balls.
Hello ma, just also wanted to confirm, I gave birth on Fri and they took a test for my baby on sun which came as 5.5 though we have been discharged with the instruction to ensure breastfeeding and come back for a test 2 days later but his eyes are still having d slight yellow color, when is this color going to Leave his eyes have also introduced early morning sun.
That is appropriate advice. DO as recommended and don’t forget to go for the 48 hours repeat check
Hello ma,just read ds now.My son is 4weeks now,he was having jaundice (6.6)after 2 days of birth Nd his eyeballs were very yellow.The test was repeated after 2 weeks Nd it increased to 7.5.Doc said there is no cause for alarm but up till now his eyeballs are still yellow but not as when he was born.shoild d test be carried out again?what can I do for his eyes to be white?tnk uuuu.
It may be worth repeating the test somewhere else because if the eyes is still yellow at 1 month that is prolonged jaundice and there are causes of prolonged jaundice that should be addressed. Also 7.5 is low for a baby who has both eyes very yellow. I recommend seeing a Paediatrician in a Teaching Hospital for further evaluation and management.
Good day ma’am
My twins were delivered 11 days ago at 35weeks .
Yellowing of the eyes was noticed on day 9 with twin one.
We were admitted @ a private clinic and both kids were placed under blue light (phototherapy) for 26hrs
FBC was done and excluded as a cause based on the blood type
The WBC were Abit high
The kids were observed and concluded that the jaundice was resolved with SB test not done because the lab scientist at that time was absent
We where discharged whithout having the values of the SB
MY QUESTION IS WHAT NEED I DO FEOM HERE
Congratulations on the birth of your twins Samuel. I will recommend just doing the SB check one more time just to be doubly sure the jaundice have truly cleared. All the best
At what level will the jaundice not increase in a child
There is nothing like that as long as the cause of jaundice has not been addressed or the jaundice cleared out of the blood, the level of jaundice may continue to rise.
My child was discharged from hospital with an SB of 7.5 at 72hrs of birth. The eyes was very yellow which later start clearing up. But he is six weeks now and the eyes is still slightly yellow, we went to hospital and another billurin test was conducted, the result came out to to be 7.6 pls is there something to worry about ma.
Hmmm….I think you should do this test in another facility because the two results should not be same when his eyes were very yellow to when they are mildly yellow.
My son was still jaundiced at 6 weeks with SB total 7.6 and 0.5. The eyes is slightly yellow. Pls should I be worried. Have been co ducting series of test now,,heamatology, ttc, t3,t4, s6pg, abdominal uss.
Kindly continue with follow up by your Paediatricians for evaluation of the prolonged jaundice though it apppears mild to me.
Good morning ma, my baby had jaundice immediately after delivery, her sb was 17.3 and 14. she was admitted for 8days thyroid test, scan were normal she was discharged to clinic. The last SB we did was 8.7 and 7 as at 6weeks of age. But her eyes are still very yellow at 8weeks what other step can we take. Note: she is feeding well on EBF, she is gaining weight
What were you told is the cause of the jaundice as that is what will determine if there is any need to do anything. You should have the conversation with the doctors managing the child. Your child has the type of jaundice called conjugated jaundice.
I had a baby who was immediately Treated for infection and latter treated for jaundice. Despite phototerapy, his SB still rose to 22. 2 EBT were done, still his SB only dropped to 14. What could be wrong doctor.
Jaundice can happen that way depending on how severe the infection was and the rapidity of breakdown of the red blood cells. Kindly read the Part 1 of this article on jaundice to understand better how jaundice occurs here JAUNDICE IN THE NEWBORN (1)
Hello Dr, my baby is 3weeks now. She is A premie of 35weeks. She got sepsis and was treated in the hospital. Then 2 days after birth jaundice was detected and they put her on phototherapy for 24h and the next day we were discharged. At one week appointment which was few days after discharge the SB was at 296umol/dL and the pediatrician asked us to do sunbath and come back after a week. We came back the following week the SB was 149umol/dL and the Dr said it a good progress and we should come back after two weeks meaning when the baby will make 4 weeks and we should continue with sunbath. But my baby’s eye are now clear, no more yellow on the face except very little yellow when I press on her back. But I am worried and I want to know if at which level is safe and the baby is safe? Thank you
I think the jaundice is resolved and there is no need to worry. Just see your Paediatrician for follow up. You don’t need to continue the sun bath anymore.
thanks for the information, do really appreciate. my sister had her baby and on the third day jaundice was notice but not early enough. so he was place in photo-light for some days but it kept increasing to 19.5 when blood transfusion was done and it drop to 12 but we see small of the yellow color in his eyes. please what’s your advice?
You did not tell me the age of the baby now but if the jaundice level is already down, there is no need to worry. There is no need to worry about the yellowish stain in the eyes as it would eventually clear.
Dear Dr
Thank you for this great information
I had my baby at 38weeks
He was said to have high SB level at 6.8. He was put under Phototherapy was discharged on 3rd day at level 9.8. We went back to check the level and at 6th day he was readmitted at 15level. We were discharged again on day at 12.6. Since then we kept checking thus:
Day 11 – 13.8
Day 16 – 11.3
Day 23 – 12.6 (last check)
We have heard all manners of opinion has to whether baby is fine. We ask the hospital to let us have a pediatrician opinion.
They said their pediatrician only attends to patients with critical cases which the general doctors can not handle
Please can we relax at this point
Thank you
There is really no need to check again. At 23 days, we are not worried about the level of jaundice your baby has as far as brain involvement is concerned. Your baby’s jaundice is probably due to one of those causes that lead to prolonged jaundice and this is what your doctors should be evaluating. It is more important to know the cause of the jaundice now than the jaundice level itself. Prolonged jaundice could be due to something immaterial like breast milk jaundice or something serious like hypothyroidism. You also did not include the second part of the result (conjugated or direct bilirubin) so it is hard to say if this unconjugated or conjugated jaundice that is prolonged as possible causes are different. Kindly ask your paediatrician this question when you see for follow up.
I don’t understand the direct and total of my sons jaundice.it shows 1.7 and 10.8 respectively
The direct is the conjugated part and the Total (both conjugated and unconjugated) is the 10.8. This is important for us to know the type of jaundice and the possible causes. You did not state the age of your baby so as to give comments on what this level signifies.
Ma can a clear eyes mean jaundice is gone?
If the baby’s eyes and skin are not yellow then the jaundice has cleared. We check for jaundice not only in the eyes but the skin and one needs blood test to confirm resolution.
Good day Dr
My baby is a month now, but had jaundice at birth,husband told me the doctor said my baby is G6pd deficiency.
What to know the cause and how to manage it, and is it a life time thing, because I can’t use anything and even her ,any doctor that will treat her must know she is G6pd deficiency.want to know if is a long time thing
G6PD deficiency is what a baby is born with…It is a genetic condition and is life long. It does not limit life as long as you avoid the agents that can trigger the red blood cells being broken down excessively. There is a list of items including drugs that individuals with G6PD deficiency must avoid. I think we will do a write up here on it but if you want to know more then join our Ask The Paediatricians Facebook group where we have discussed the topic already.
Thank you so much for this great information.
I had my 2nd baby in 2018, his eyes were yellow and his skin showed he had jaundice, which my mum and I noticed from birth, but when I spoke to the Pediatrician, we were asked to be do SB which showed it was normal, infact, we did the SB 4 different times, all the results showed it was normal which we knew it wasn’t. We were discharged because the result stated he is ok. We kept going to the hospital, knowing he had jaundice, but the Pediatricians said otherwise. It was on the 7th day of birth we met the consultant and she said my son had jaundice and it was really high, she said this without asking for the results of the SB we did, that is, she carried him and by mere look, she confirmed it. My question is, how come the test was showing that the jaundice was normal, but mere looking at him, you would know he has high jaundice.
The laboratory may be giving wrong information or perhaps the interpretation was wrong. You did not say the figure so it is hard to say if it is normal or not (wrongfully interpreted).
Hello Doc, please at what age can we say a child has survived from effect of jaundice (for the fear of it not well managed at infancy)
There is no age in particular but as long as the child’s development is age appropriate; there is no need to worry.
Doc, Good evening… my son is exactly one week old, I noticed the change in his eye color about 2days after birth, took him to the hospital where the conducted the SB test and it was 17.3 and he was placed on phototherapy and today the test was repeated and it’s now 11.1. When I asked if we should continue with phototherapy the doctor said NO, that we should go home and repeat the test on Saturday, but I want to know if 11.1 is dangerous and still needs phototherapy or will it come down on its own
The level of 11.1 is not dangerous but the child has to have repeat test to make sure the jaundice level keeps falling. For urgent questions and answers, please post to our Facebook group