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Hi Tina, my understanding is that normal bright 'white'
daylight in a well lit room is adequate to facilitate the conversion of
bilirubin in it's fat soluble form stored in the tissue, to the water soluble
form, which is then returned to the bloodstream for processing through the
GI system for excretion.
I encourage all parents to assist the processing
of physiological jaundice in the early days of their baby's life by having the
baby in the best lit room during daylight hours. I advise them to follow
the best natural light in the house as the day passes, maximising
the baby's exposure to indirect natural (white)
daylight particularly if the baby is visibly jaundiced. Of course,
the other important signs are monitored closely too - feeding well and
frequently, wee-ing (noting colour of urine), poo-ing, not too sleepy etc.
I find early attention to assisting the natural physiological process utilising
natural light minimises the incidence and severity of physiological jaundice in
most cases. I do not recommend 'sun bathing' in direct sunlight indoors or
outdoors, especially here in WA where even winter direct sun through glass can
be very hot. Regards,
Lois
Sent: Friday, July 11, 2003 5:51 PM
Subject: [ozmidwifery] sun baths for
jundice
Hi, just aquick question after Marilyn talked of
sun baths for jaundice (below). What is the latest info on this?
When I had my daughter in Townsville 9+ years ago I was told when she
developed jaundice to sun her religously in am & pm for a few days between
SBR's. I was told this again when my second child was born (7 years
ago), but this time in sunlight filtered by window. Then when he
was 8 months old I started my midwifery education (in Townsville) &
we were taught that it was no longer safe & we were not to advise parents
to do this (due to high skin cancer rates in N.Q). What is common
practice regarding this. I have come across midwives still recommeding
to sun.
Tina H. Brisbane
----- Original Message -----
Sent: Saturday, July 12, 2003 1:00
AM
Subject: Re: [ozmidwifery] whats
happening ?
Hi Lynne: yes it is weird how transfers can
cluster sometimes. Exhausting. Regarding the Mg SO4 and >BP, one young
woman I worked with in Seattle developed high BP after we made the hospital
transfer(we transferred for maternal exhaustion, she had been labouring hard
for 2 days and was still 3cm, BP had been stable at home, no other sx except
that she had had heartburn/reflux throughout the pregnancy and i have
wondered since if this masked any epigastric pain) anyway BP went from
120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally
160/100, this was after the epidural but while we were awaiting the stat
liver function tests which the ob ordered "just in case" actually
apologising for ordering them as we all thought the elevated BP wasdue to
the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much
careful monitoring, she went to complete in 2hrs and pushed her baby out in
between vomitting from the Mg SO4. There was thick to mod mec liquor too,
baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds
until her bloods were normal and BP stable, baby very jaundiced really
should have had phototherapy but parents declined and went home. Mum also
somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care,
lost >10% in first week, milk took a good 7 days to really come in once
it did baby made a slow but steady weight gain. WE, the midwives were
somewhat anxious, but paed was ok with it doing homevisits and sun baths for
baby (trust me the UV index in Seattle is not to be worried about). Long
story, sorry. So yes the milk did come in just later.
marilyn
----- Original Message -----
Sent: Thursday, July 10, 2003 2:14
PM
Subject: Re: [ozmidwifery] whats
happening ?
Hi Jan
Must be something in the water - I had 3
t/f to hosp as well in the past 2 months. One - a primigravida - C/B
after BP shot through the roof antenatally and SROM at 37 weeks. She did
labour, but for whatever reason, her body did not open, and her BP
sneaking up higher and higher despite Mg So4 and hydrallazine. Home now
but lactation did not establish and she has tried everything. Is anyone
aware of MgSo4 or hydrallazine having an impact on lactation?
Another had the most amazing labour - had
been labouring for quite some time before she called (as she and partner
had been happy working together). First baby. After some time I asked if I
could examine her - something wasn't right - she had the most awful back
pain and the babe was not OP - the head VERY deep in the pelvis and had
been for some weeks prior to birth. Head was +2 and covered with lower
segment. Looking for cervix and finally located it very high and anterior
behind the right obturator foramen. Pinhole in size and the lower
segment/cervix paper thin. No wonder she had this dreadful backache. I
began to massage the tine hole in her cervix very gently - within 5 mins
had opened to 3-4. Another 2 hrs later, still awful backache (imagine the
stretch on her posterior ligaments), and still the same. Some more gentle
massage and the cervix opened to 5-6. Into bath, but backache absolutely
unbearable after another hour. Penney asked me to massage again, but my
short little fingers could only coax it to 8 where it stayed for the next
hour. She decided to go to hosp for some pain relief (!), and when we
arrived I organised an epidural for her. Asked to check her again before
the anaesthetist arrived, because it might change what she wanted to do -
anterior lip, backache gone and she pushed out her baby after I phoned the
anaesthetisit to say we wouldn't be requiring him after all. All of us
crying - one exhausted but oh so triumphant woman.
Third primigravida, who laboured beautifully
at home and the baby just did not come past caput on view despite
everything we tried. So decided to go to hosp, where she had a reseonably
difficult ventouse - no analgesia (her choice) - she just wanted to have
the baby. Hospital staff were wonderful in each case - women and their
partners treated with respect and each of the women has come away feeling
good about the transfer.
Whew! Sorry about the length of this posting
but needed to talk! Thanks for the opening, Jan.
From another very tired and continually
learing midwife - Lynne :-)
----- Original Message -----
Sent: Thursday, July 10, 2003 11:14
PM
Subject: [ozmidwifery] whats
happening ?
bad run?
unbelievable 5 births this month3 c/s trans
from homebirth 1 normal del priv hosp 1 normal del home what is
happening bewildered tired and yuk jan
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