Kalo saya jadi mbak seeh, saya akan bawa pulang baby nya.
Lagian pasti kita bakal lebih telaten dibanding suster2 di RS.
Jaundice itu emang banyak terjadi pd tiap ada baru lahir karena fungsi
hatinya yg belum sempurna.
Ini saya attach artikel ttg jaundice ok..
Moga membantu..
Patty -Viany's Mom-
http://www.kellymom.com/newman/07jaundice.html
Breastfeeding and Jaundice
Handout #7. Jaundice. Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
PDF handout
Introduction
Jaundice is due to a buildup in the blood of bilirubin, a yellow pigment
that comes from the breakdown of old red blood cells. It is normal for old
red blood cells to break down, but the bilirubin formed does not usually
cause jaundice because the liver metabolizes it and gets rid of it into
the gut. The newborn baby, however, often becomes jaundiced during the
first few days because the liver enzyme that metabolizes bilirubin is
relatively immature. Furthermore, newborn babies have more red blood cells
than adults, and thus more are breaking down at any one time. If the baby
is premature, or stressed from a difficult birth, or the infant of a
diabetic mother, or more than the usual number of red blood cells are
breaking down (as can happen in blood incompatibility), the level of
bilirubin in the blood may rise higher than usual levels.
Two Types of Jaundice
The liver changes bilirubin so that it can be eliminated from the body
(the changed bilirubin is now called conjugated, direct reacting, or water
soluble bilirubin--all three terms mean essentially the same thing). If,
however, the liver is functioning poorly, as occurs during some
infections, or the tubes that transport the bilirubin to the gut are
blocked, this changed bilirubin may accumulate in the blood and also cause
jaundice. When this occurs, the changed bilirubin appears in the urine and
turns the urine brown. This brown urine is an important clue that the
jaundice is not "ordinary". Jaundice due to conjugated bilirubin is always
abnormal, frequently serious and needs to be investigated thoroughly and
immediately. Except in the case of a few extremely rare metabolic
diseases, breastfeeding can and should continue.
Accumulation of bilirubin before it has been changed by the enzyme of the
liver may be normal"physiologic jaundice" (this bilirubin is called
unconjugated, indirect reacting or fat soluble bilirubin). Physiologic
jaundice begins about the second day of the baby's life, peaks on the
third or fourth day and then begins to disappear. However, there may be
other conditions that may require treatment that can cause an exaggeration
of this type of jaundice. Because these conditions have no association
with breastfeeding, breastfeeding should continue. If, for example, the
baby has severe jaundice due to rapid breakdown of red blood cells, this
is not a reason to take the baby off the breast. Breastfeeding should
continue in such a circumstance.
So-called Breastmilk Jaundice
There is a condition commonly called breastmilk jaundice. No one knows
what the cause of breastmilk jaundice is. In order to make this diagnosis,
the baby should be at least a week old, though interestingly, many of the
babies with breastmilk jaundice also have had exaggerated physiologic
jaundice. The baby should be gaining well, with breastfeeding alone,
having lots of bowel movements, passing plentiful, clear urine and be
generally well (handout #4 Is My Baby Getting Enough Milk?). In such a
setting, the baby has what some call breastmilk jaundice, though, on
occasion, infections of the urine or an under functioning of the baby's
thyroid gland, as well as a few other even rarer illnesses may cause the
same picture. Breastmilk jaundice peaks at 10-21 days, but may last for
two or three months. Breastmilk jaundice is normal. Rarely, if ever, does
breastfeeding need to be discontinued even for a short time. Only very
occasionally is any treatment, such as phototherapy, necessary. There is
not one bit of evidence that this jaundice causes any problem at all for
the baby. Breastfeeding should not be discontinued "in order to make a
diagnosis". If the baby is truly doing well on breast only, there is no
reason, none, to stop breastfeeding or supplement with a lactation aid,
for that matter. The notion that there is something wrong with the baby
being jaundiced comes from the assumption that the formula feeding baby is
the standard by which we should determine how the breastfed baby should
be. This manner of thinking, almost universal amongst health
professionals, truly turns logic upside down. Thus, the formula feeding
baby is rarely jaundiced after the first week of life, and when he is,
there is usually something wrong. Therefore, the baby with so-called
breastmilk jaundice is a concern and "something must be done". However, in
our experience, most exclusively breastfed babies who are perfectly
healthy and gaining weight well are still jaundiced at five to six weeks
of life and even later. The question, in fact, should be whether or not it
is normal not to be jaundiced and is this absence of jaundice something we
should worry about? Do not stop breastfeeding for breastmilk jaundice.
Not-enough-breastmilk Jaundice
Higher than usual levels of bilirubin or longer than usual jaundice may
occur because the baby is not getting enough milk. This may be due to the
fact that the mother's milk takes longer than average to "come in" (but if
the baby feeds well in the first few days this should not be a problem),
or because hospital routines limit breastfeeding or because, most likely,
the baby is poorly latched on and thus not getting the milk which is
available (handout #4 Is My Baby Getting Enough Milk?). When the baby is
getting little milk, bowel movements tend to be scanty and infrequent so
that the bilirubin that was in the baby's gut gets reabsorbed into the
blood instead of leaving the body with the bowel movements. Obviously, the
best way to avoid "not-enough-breastmilk jaundice" is to get breastfeeding
started properly (handout #1 BreastfeedingStarting Out Right).
Definitely, however, the first approach to not-enough-breastmilk jaundice
is not to take the baby off the breast or to give bottles (see Handout B:
Protocol to Increase Breastmilk Intake by the Baby). If the baby is
nursing well, more frequent feedings may be enough to bring the bilirubin
down more quickly, though, in fact, nothing needs be done. If the baby is
nursing poorly, helping the baby latch on better may allow him to nurse
more effectively and thus receive more milk. Compressing the breast to get
more milk into the baby may help (handout #15 Breast Compression). If
latching and breast compression alone do not work, a lactation aid would
be appropriate to supplement feedings (handout #5 Using a Lactation Aid).
See also the handout: Protocol to Increase Breastmilk Intake by the Baby.
See also the website www.thebirthden.com/Newman.html for videos to help
use the Protocol by showing how to latch a baby on, how to know the baby
is getting milk, how to use compression, as well as other information on
breastfeeding.
Phototherapy (Bilirubin Lights)
Phototherapy increases the fluid requirements of the baby. If the baby is
nursing well, more frequent feeding can usually make up this increased
requirement. However, if it is felt that the baby needs more fluids, use a
lactation aid to supplement, preferably expressed breastmilk, expressed
milk with sugar water or sugar water alone rather than formula.
From: "Lif Rahayu" <[EMAIL PROTECTED]>
Reply-To: balita-anda@balita-anda.com
To: balita-anda@balita-anda.com
Subject: Re: [balita-anda] bilirubin
Date: Thu, 7 Sep 2006 11:01:50 +0700
Ibu,
kalau dedek saya dulu seh, normalnya kalau bisa di bawah 10 ya, kalau antara
10.1-12-an, boleh dibawa pulang, dgn catatan harus banyak mimik susu dan
sering dijemur. Kalo bayinya susah mimik susu, ya harus dipaksa, kalo bisa,
asi ibunya diperas terus diberikan lewat botol susu.
jangan seperti saya ya, saking pedenya dengan asi sendiri, waktu dedek
dibawa pulang, bilirubinnya 11, nah saya tetekin aja pakai asi, padahal
dedeknya males menghisap. alhasil pada saat kontrol, seminggu kemudian,
bilirubinnya jadi 15 deh, kepaksa disinar selama 2 hari. harusnya seh saya
kasih juga peresan asi pake botol....
hitung deh ya, dalam satu hari harus habis kira2: 150 ml x berat badan bayi,
nah bayi saya 3.5 kg x 150 ml= 525 ml dalam satu hari.
Terus juga dijemurnya mesti 30 menit antara jam 7 sampai jam 9, dan dibuka
semua bajunya pada saat dijemur ya.....
Oh iya, kalo asi ekslusif, kuningnya emang agak lama, tapi gak papa koq,
kalo masih 10-12an mah. Yang bahaya di atas 25, bisa mengakitkan keracunan
otak....
ssemoga membantu,
Mama Nayma
http://www.keluargaalfirano.blogspot.com
On 9/7/06, Lusiana, Lusiana - ID (Marketing Accounting) <
[EMAIL PROTECTED]> wrote:
Dear all,
Berapa sih normalnya skor untuk bilirubin? Kalau bilirubin bayinya masih
12.1 apa boleh dibawa pulang?
thanks
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