Jaundice Flashcards
Important history for a baby with jaundice (10)
Term or preterm, type of delivery, risk factors for sepsis, maternal blood group, breast vs formula fed, volume and frequency of feeds, waking for feeds, wet nappies/stool, when was it noticed and have they already required treatment
Assessment of a jaundiced baby
Weight compared to birth, observations, alert or lethargic, top to toe check, abdomen for masses and stool colour
What is acceptable weight loss after birth
10% for formula fed and 12.5% for breast fed
When should a child be back to birth weight
By 3 weeks of age
What is jaundice
Yellowing of skin and sclera due to high levels of bilirubin in the blood
Cause of physiological jaundice
High concentrations of RBCs in the foetus and neonate which are more fragile than normal and less developed liver function - lots of bilirubin released which was normally excreted by placenta
What is physiological jaundice
Normal rise of bilirubin shortly after birth causing mild yellowing - usually resolves by 10 days
Causes of increased production of bilirubin (8)
Haemolytic disease of newborn, ABO incompatibility, haemorrhage, cepalo-haematoma, polycythaemia, sepsis and DIC, G6PD def
Causes of decreased clearance of bilirubin
Prematurity, breast milk jaundice, neonatal cholestasis, extrahepatic biliary atresia, hypothyroid and hypopituitary, Gilbert syndrome
When is jaundice pathological
IF present within first 24 hours of life
What causes premature jaundice
Exaggerated due to immature liver, increases risk of complications
What is Kernicterus
Brain damage due to high bilirubin levels
What is breast milk jaundice
Babies that are breastfed are more likely to have neonatal jaundice as breast milk inhibits the ability of the liver to process the bilirubin
What is haemolytic disease of the newborn
Cause of haemolysis and jaundice of newborn. By incompatibility between the rhesus antigen on the surface of RBCs of the mother and fetus
How long is prolonged jaundice
More than 14 days in term babies and more than 21 days in preterm babies
