EEk! so sorry it happened again the email just went off incomplete. As I was trying to write, it really depends on how old the baby is as to when treatment is implemented. Detectable jaundice within the first 24hours of birth has a high index of suspicion for needing treatment and is most likely NOT normal physiological jaundice: most likely due to haemolysis of the baby's red blood cells in-utero (due to a variety of pathologies the most common being Rh and/or ABO incompatabilities and antibody formation) and together with the normal physiological jaundice that ALL newborns will experience could overwhelm the newborn's ability (via liver and gut) to metabolise the biliribin. Jaundice that shows up from day 3 on is usually physiological jaundice resulting from the normal breakdown of the excess fetal red blood cells needed in-utero to supply oxygen in the relativel low oxygen environment of the uterus compared to the higher oxygen environment of the air. So the newborn is usually able to handle this jaundice however it can be compounded by pre-maturity and also birth trauma and subsequent bruising. As has been said, so long as baby is feeding frequently, peeing and pooing appropriately, afebrile, and not lethargic/irritable then all is well.
marilyn ----- Original Message ----- From: "Mary Murphy" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, January 31, 2004 7:04 PM Subject: Re: [ozmidwifery] URGENT INFO NEEDED > Hi, on further thought about recent cases, mostly if the baby is alert and > feeding, I use lots of strong natural light and observe. I did have one > baby that we knew would have jaundice because of family history. I took him > to the teaching hospital for children,PMH on day 4. His SBR was 310. We > were sent home without phototherapy and advice to keep him in the light and > regular feeding. I went back for a followup SBR the next day.. same result > and same advice. I must admit I was surprised, but it was 2 different paeds > and a top hospital for children. The baby was fine. Cheers, MM > > > > Reading my Maggie Myles, she suggests that SBR levels above 250 on a full > > term baby may require phototherapy and levels above 340 are approximate > > indications for exchange transfusion in infants above 35 weeks gestation. > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
