Jaundice (Jondis)/ Yellow Fever/ Demam Kuning

Below are some info on Jaundice.. babies nowadays senang dapat.. just a tip or two to prevent and kalau kene gak.. what to expect and how to handle it :)

Facts About Jaundice

Most jaundice in newborn babies is a normal event and is not serious. In most cases, this jaundice will disappear after a few days, often without any special treatment. Also, once this type of jaundice disappears, there is no evidence that it will appear again or that it has any lasting effects on the baby.

A common condition in newborns, jaundice refers to the yellow color of the skin and whites of the eyes caused by excess bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells.

Normally bilirubin passes through the liver and is excreted as bile through the intestines. Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body. Reasons for this include:
1. A newborn baby's still-developing liver may not yet be able to remove adequate bilirubin from the blood.
2. More bilirubin is being made than the infant's liver can handle.
3. Too large an amount of bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool.

High levels of bilirubin - usually above 20 mg - can cause deafness, cerebral palsy, or brain damage in some babies. In rare cases, jaundice may indicate the presence of hepatitis. The American Academy of Pediatrics recommends that all infants should be examined for jaundice within a few days after being born.

What does the word "jaundice" mean?
Jaundice comes from the French word jaune, which means yellow. When it is said that a baby is jaundiced, it simply means that the color of his skin appears yellow. Jaundice in the infant appears first in the face and upper body and progresses downward toward the toes. Premature infants are more likely to develop jaundice than full-term babies.

What causes the skin to appear yellow?
The yellowish coloration is caused by an excess amount of bilirubin in the baby's skin. Bilirubin is a yellowish-red pigment. Normally, small amounts of bilirubin are found in everyone's blood. When too much bilirubin is made, the excess is dumped into the bloodstream and is deposited in tissues for temporary storage.

Why would a baby have excess bilirubin in his blood?
Bilirubin is formed and released into the bloodstream when red blood cells are broken down. Newborns have a high red blood cell volume; this increases the bilirubin load. The bilirubin is then carried to the liver where it is processed and eventually excreted from the body.

Types of Jaundice
There are several types of newborn jaundice. The following are the most common:

Physiological (normal) jaundice:
occurring in more than 50% of newborns, this jaundice is due to the immaturity of the baby's liver, which leads to a slow processing of bilirubin. It generally appears at 2 to 4 days of age and disappears by 1 to 2 weeks of age.

Jaundice of prematurity:
this occurs frequently in premature babies since they take longer to adjust to excreting bilirubin effectively.

Breast milk jaundice:
in 1% to 2% of breastfed babies, jaundice can be caused by substances produced in their mother's breast milk that can cause the bilirubin level to rise above 20 mg. These substances can prevent the excretion of bilirubin through the intestines. It starts at 4 to 7 days and normally lasts from 3 to 10 weeks.

Blood group incompatibility (Rh or ABO problems):
if a baby has a different blood type than the mother, the mother might produce antibodies that destroy the infant's red blood cells. This creates a sudden buildup of bilirubin in the baby's blood. Incompatibility jaundice usually begins during the first day of life. Rh problems once caused the most severe form of jaundice, but now can be prevented with an injection of Rh immune globulin to the mother within 72 hours after delivery, which prevents her from forming antibodies that might endanger any subsequent babies.

Symptoms and Diagnosis
Jaundice usually appears around the second or third day of life. It begins at the head and progresses downward. A jaundiced baby's skin will appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant's eyes to appear yellow.Since many babies are now released from the hospital at 1 or 2 days of life, parents should keep an eye on their infants to detect jaundice.A simple test for jaundice is to gently press your fingertip on the tip of your child's nose or forehead. If the skin shows white (this test works for all races) there is no jaundice; if it shows a yellowish color, you should contact your child's doctor to see if significant jaundice is present.At the doctor's office, a small sample of your infant's blood can be tested to measure the bilirubin level. The seriousness of the jaundice will vary based on your child's age and the presence of other medical conditions.

When to Call Your Child's Doctor
Your child's doctor should be called immediately if jaundice is noted during the first 24 hours of life, the jaundice involves arms or legs, your baby develops a fever over 100 degrees Fahrenheit (37.8 degrees Celsius), or if your child starts to look or act sick. (In children under age 5, temperatures should be taken rectally or aurally.) Call your child's doctor if the color deepens after day 7, the jaundice is not gone after day 15, your baby is not gaining sufficient weight, or if you are concerned about the amount of jaundice in your baby's skin.

Treatments
In mild or moderate levels of jaundice, by 5 to 7 days of age the baby will take care of the excess bilirubin on its own. If high levels of jaundice do not clear up, phototherapy - ultraviolet light that helps rid the body of the bilirubin by altering it or making it easier for your baby's liver to get rid of it - may be prescribed.


More frequent feedings of breast milk or formula to help infants pass the bilirubin in their stools may also be recommended. In rare cases, a blood exchange may be required to give a baby fresh blood and remove the bilirubin.

If your baby develops jaundice that lasts more than a week, your doctor may ask you to temporarily stop breastfeeding. During this time, you can pump your breasts so you can keep producing breast milk and you can start nursing again once the condition has cleared.

If the amount of bilirubin is high, your baby may be readmitted to the hospital for treatment. Once the bilirubin level drops, however, it is unlikely it will increase again.

What happens when a newborn baby has jaundice?
Physiologic jaundice is usually seen around the second or third day of life. The nurse or doctor caring for the baby will notice it and may request a blood test. Based on the results of the test and based on the general condition of the baby, the doctor will decide whether treatment should be started. If no treatment is felt necessary, the jaundice will usually decrease after a week and disappear within two weeks. If treatment is required, commonly a Bililight is used. This treatment is also known as phototherapy. Another name for the light is a Bilirubin Reduction Light.

What is a Bililight and why is it used?
A Bililight consists of a series of fluorescent lights that are placed over the baby's bed. The light helps the baby to get rid of bilirubin found just beneath the surface of the skin. It does this by changing the structure of the bilirubin, thereby making it easier to be excreted by the liver.

How is the Bililight used? How long is it used?
The Bililight is placed over the baby's bed, which will be either an Isolette or a radiant warmer bed. The baby is undressed to provide maximum skin exposure; the baby's skin will not darken or burn under this light. The baby may be under the light for several days. Laboratory tests and physical appearance guide the doctor in his evaluation of the baby's progress. The light will be discontinued at the earliest possible time.

How is the baby cared for during phototherapy?

Masks are placed over the baby's eyes to prevent exposure to the bright light. The baby's position is changed frequently to assure that all areas of the baby's skin are exposed to light and also to assure the baby's comfort. The baby may be fed under the light or may be taken out for the feedings, according to the doctor's instructions.

How do babies tolerate the light?
Each baby is an individual and, thus, unique in his response to this treatment. Some babies are very fussy because they miss being wrapped tightly in their blankets. Other babies sleep very contentedly.

While under the light, the baby usually has frequent and loose bowel movements. In some circumstances, his stools are greenish in color. This is temporary and should stop when treatment is discontinued.

The medical staff at the hospital knows that you are concerned about your baby and realizes that having your baby underneath the lights limits your contact with the baby. Remember, this treatment lasts only a few days. In no time at all, you and your baby will be ready to go home.

There is a petua org dulu dulu tuk ubatkan sakit ni.. if and I repeat IF.. the sakit is MILD... not so bad.. tak kuning sangat.. all you can do is...

1. Gather daun inai and daun belimbing buluh (the small masam belimbing yang org buat masak lauk lemak)
2. Rebus dua dua daun ni in a periuk sampai keluar warna kuning dari inai
3. Tunggu sejuk or mix together ngan air sejuk suapaya jadi suam
4. Mandikan baby yg ada sakit kuning

Insya Allah .. berkesan... Indah masa lahir dulu takde.. bila bawak balik Ipoh ada sket sket.. so my mom mandikan die guna air rebusan daun inai & daun belimbing buluh ni.. alhamdulillah hilang kuningnya ...