Despite medical information on jaundice, many mothers do not know how to treat the disease in their children.
Mrs Onyekachi Okafor is one of them. When she had her baby, it was discovered that she was infected with jaundice. She soaked unripe pawpaw in sterilised water and administered on the child. Her mother in-law and sister also suggested to her, the use of alum, ampiclox, glucose and the baby’s exposure to sunlight.
But, according to medical authorities, these are wrong ways of managing jaundice. They said if detected early, the disease can be treated without complications.
Members of the Nigerian Society of Neonatal Medicine said: "Jaundice occurs because of a normal increase in red blood cell breakdown and the fact that their immature livers are not efficient at removing bilirubin from the bloodstream.Jaundice in newborns most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. Jaundice may also be caused by other medical conditions."
Neonatals are babies from age one day to 28 days (or one month). And their deaths account for 42 per cent of the 60 per cent of child mortality rate in the country.
According to the President of the society, Angela Okolo, a Professor of Paediatrics at the University of Benin Teaching Hospital (UNIBEN), "there are sundry reasons neonatals die, among which are: complications of pregnancy (such as preeclampsia, a pregnancy-related form of high blood pressure); complications involving the placenta, umbilical cord and membranes (bag of waters); infections and Asphyxia (lack of oxygen before or during birth). Prematurity (before 37 completed weeks of pregnancy) is another most common cause of neonatal death.
"Respiratory distress syndrome (RDS) because many babies develop this breathing problem each year. Babies with RDS have immature lungs that lack a protein called surfactant that keeps small air sacs in the lungs from collapsing. Intraventricular hemorrhage (IVH), for premature babies sometimes develop bleeding in the brain. While mild brain bleeds usually resolve themselves with no or few lasting problems, severe bleeds often result in brain damage or even death.
"Necrotising enterocolitis (NEC): Some premature babies may develop this intestinal problem, a serious inflammation of the bowel. And infections as premature babies have immature immune systems and sometimes develop serious infections, such as pneumonia (lung infection), sepsis (blood infection) and meningitis (infection of membranes surrounding the brain and spinal cord). But the leading cause is jaundice."
On how the disease occurs, she said: "In newborn babies a degree of jaundice is normal. It is due to the breakdown of red blood cells (which release bilirubin into the blood) and to the immaturity of the newborn's liver (which cannot effectively metabolise the bilirubin and prepare it for excretion into the urine). Normal neonatal jaundice appears between the second and fifth days of life and clears with time. Neonatal jaundice is also referred to as neonatal hyperbilirubinemia and physiologic jaundice of the newborn."
Lamenting how cases are mishandled, Dr Imoh Ukpong of the Primary Health and Child Development Agency (PHCDA), said there is undue delay in bringing inffected babies to health care facilities. Also, some mothers erroneously believe that exposing babies with jaundice to early morning sunlight, giving glucose in water or ampiclox is an effective treatment. The use of camphor on the clothes and mentholatum on the head worsens jaundice.
The Secretary of the society, Dr Sylvester Alikah, Irrua Specialist Teaching Hospital, Edo State said when a baby dies in the first 28 days of life, it is called neonatal death. And the psychosocial impact among mothers with perinatal loss is huge.
"Hence, the Nigerian Society of Neonatal Medicine is the coming together of doctors who look after children, particularly, newborn babies. And our objectives are to improve standard of newborn care with focus on community level activities. In other words, help children healthy children remain so, treat sick children and protect the interest of children.
"Jaundice is common among babies. A survey involving 42 health institutions by our society found that it occurs in one out of every five babies admitted in hospitals. It causes death in one of every 10 babies who have it and brain damage result in one of every 20 babies who have it."
Prof Vinod Bhutani, Newborn Medicine (Neonatology) of the Stanford University, United States said there is no need to wait for see yellow in the schlera to confirm the presence of jaundice in babies, adding: "Early detection is vital.
"The yellow in any of these areas is an emergency that should be promptly reported. If delayed, it can become more severe, and babies will not be able to suck and may even convulse. The consequences of poorly managed jaundice can be disastrous and can result in brain damage or death," he warned.
Source:thenation
