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close this bookPostpartum Care of the Mother and Newborn: A Practical Guide (WHO; 1998; 82 pages)
View the documentACKNOWLEDGEMENTS
View the documentEXECUTIVE SUMMARY
open this folder and view contents1 INTRODUCTION
open this folder and view contents2 WOMEN'S PERCEPTION OF POSTPARTUM PROBLEMS
open this folder and view contents3 MAJOR MATERNAL HEALTH CHALLENGES IN THE POSTPARTUM PERIOD
open this folder and view contents4 MATERNAL NUTRITION
close this folder5 INFANT HEALTH CHALLENGES IN THE POSTNATAL PERIOD
View the document5.1 General considerations
open this folder and view contents5.2 Life threatening infant morbidity
close this folder5.3 Other serious infant morbidity
View the document5.3.1 Disturbance of thermoregulation
View the document5.3.2 Jaundice
View the document5.3.3 Ophthalmia neonatorum
View the document5.3.4 Neonatal herpes infection
View the document5.3.5 Hepatitis B
View the document5.3.6 Human immunodeficiency virus (HIV) infection
View the document5.4 Conclusion
open this folder and view contents6 BREASTFEEDING
open this folder and view contents7 BIRTH SPACING
open this folder and view contents8 HIV/AIDS INFECTION
open this folder and view contents9 IMMUNIZATION
open this folder and view contents10 CARE AND SERVICE PROVISION IN THE POSTPARTUM PERIOD
View the document11 RECOMMENDATIONS
View the document12 REFERENCES
View the documentANNEX 1 CLASSIFICATION OF PRACTICES IN POSTPARTUM CARE
View the documentANNEX 2 LIST OF PARTICIPANTS
View the documentSAFE MOTHERHOOD RESOURCES
View the documentBACK COVER
 

5.3.2 Jaundice

It is both normal and common for healthy newborn infants to become jaundiced. In term infants this occurs in about 15% and more frequently in preterm. Jaundice is a sign not a disease as long as the level of bilirubin does not go over values considered to be safe. The most common jaundice in term newborn infants is physiological and it seldom reaches severity that might be harmful.

In a small proportion of infants jaundice is a sign of serious disease. In those cases it usually appears early and/or it becomes severe. The most common causes of severe jaundice are haemolytic diseases of different etiologies and infections. In countries with no prevention of Rh-iso-immunization or with other specific problems such as glucose-6-phosphate dehydrogenase deficiency severe forms of jaundice are more frequent than elsewhere. Jaundice in preterm infants can be a combination of the immature organism not being able to metabolize bilirubin, and diseases. It should be considered a more serious problem than in term infants. Poor clinical practices can contribute significantly to the level of jaundice.

Phototherapy is an effective treatment for most newborns with moderately severe jaundice. Phototherapy is considered a safe intervention without known side-effects. However, it usually involves hospital admission of the infant with separation from the mother, and negative consequences for breastfeeding and mother-infant relation. Interventions aimed at lowering serum bilirubin values are performed too often in term infants (Newman & Maisels 1990, 1992). When the values of bilirubin exceed levels considered safe exchange transfusion is indicated - at what exact values will dependent on the age of the infant, gestational age and other problems (Provisional committee for quality improvement and subcommittee on hyperbilirubinaemia 1994). It has never been proven that bilirubin values <340 ìmol/l are harmful for term infants not suffering from haemolytic disease (Scheidt et al 1990, Newman & Klebanoff 1993, Seidman et al 1994). However, all these recommendations are based on observations and studies in developed countries.

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