Your Pregnancy

Q&A I’m worried about baby jaundice

- DR MARETHA COMBRINK PAEDIATRIC­IAN

SHOULD YOUR INFANT REQUIRE TREATMENT FOR JAUNDICE, YOUR PAEDIATRIC­IAN WILL RECOMMEND PHOTOTHERA­PY.

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Please note that experts unfortunat­ely cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.

Is there anything I can do to avoid my newborn getting jaundice? My first didn’t. She was born in Germany in winter, and I remember that they gave her vit D supplement (I think) that could have prevented it. My second was born here and developed jaundice, even though I did nothing differentl­y. It was so bad that we struggled to wake her up for a feed. With the pandemic I really want to avoid having to go back to hospital for treatment with my third baby who arrives soon. Also, of course, I have two other children at home.

DR COMBRINK ANSWERS: During pregnancy your baby is equipped with an adequate amount of red blood cells to increase the oxygen-carrying capacity in an oxygen-poor environmen­t. After birth, your baby starts to breathe on their own in an oxygen-rich environmen­t. As there is no need for increased red blood cells, they are broken down. Bilirubin is formed during the breakdown of haemoglobi­n (part of the red blood cells that carry O2) and causes a yellow discolorat­ion of a newborn baby’s skin and eyes that we call jaundice. Physiologi­cal jaundice is visible between days two to three of life, peaks between days three to five and starts dropping between days five and seven. Factors that may aggravate the level of physiologi­cal jaundice is prematurit­y, low birth weight, poor feeding, infection or bruising due to birth trauma. Early onset jaundice (within the first 24 hours of life) and jaundice that persists beyond 14 days are causes for concern and need to be investigat­ed. Deteriorat­ion of severe physiologi­cal jaundice can be prevented by nursing infants at least eight to 12 times per day for the first week after birth and regularly checking for jaundice. Should your infant require treatment for jaundice, your paediatric­ian will recommend photothera­py.

Photothera­py is most effective with blue light of 425-475nm wavelength. Medical photothera­py equipment is available for rent in metropolit­an areas via midwives or private nursing staff. Feel free to enquire with your paediatric­ian or the hospital where you will deliver. If you feel uncomforta­ble with home treatment, the equipment is readily available at hospitals as well – however, this will require re-admission. European countries routinely advise vitamin D supplement­ation for children under 1 year of age, due to limited sun exposure. Your baby needs vitamin D to absorb calcium and phosphorus. Too little vitamin D can cause rickets, a softening and weakening of bones. South African guidelines do not currently recommend routine use of vitamin D in the prevention or treatment of jaundice. ●

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