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The reason i called the indirect sun exposure of a
jaundiced baby a "sunbath" was to get the parents to take the babies clothes
off. Being in a naturally well lit room isn't going to be of much help for
jaundice if the baby is covered from head to toe. In Seattle, especially in
winter, this meant getting the room heated so that the baby didn't get
cold for the few minutes of indirect sun. It also meant illiminating drafts.
Because of the ambient temperature alone, you would never take an unclothed baby
outside for a sunbath! Obviously in Australia, especially in the tropics, the
reverse is true, and of course you need to protect the baby from overexposure to
the sun.
The baby I was referring to was in fact jaundiced
from head to toe, quite yellow scrotum, but parents declined bililights. They
did have one window that got reasonable light for some of the day. Daylight at
the time of the year this baby was born (late November) was from 10am until 4pm.
Not much. Most houses in Seattle were quite dark without artificial light, so it
was important to know just how much natural light got into the room. In this
case sufficient light since the baby started breastfeeding well, and the
jaundice was eliminated by day 10. It is important to know the type of homes
babies are living in. In North America for some reason the homes I lived in and
visited were quite dark without artificial light, I remember noticing this
right from the get go. Don't have any idea why this is but at least in my
experience it was so. Dark enough that you had to turn a light on to read
in the middle of the day. Australian homes again, the ones I have lived in and
the ones I've visited are by contrast very well lit by natural light, so so long
as the baby is warm, a few minutes without clothes, inside, should be
sufficient.
marilyn
----- Original Message -----
Sent: Saturday, July 12, 2003 12:26
AM
Subject: Re: [ozmidwifery] sun baths for
jundice
I was talking about Seattle, Washington where the
sunlight is very very different than here. A sun bath in Seattle is a very
different thing to a sunbath in Townsville, Cairns or probably anywhere except
Hobart in Australia. Neverhless i took it for granted it would be indirect
sun.
marilyn
----- Original Message -----
Sent: Friday, July 11, 2003 2:51
AM
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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