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Saturday, 1 June 2013

yr down with jaundice =(

  1. 20 May: 8.2 - initial test result
  2. 22 May: 6.5 - after phototherapy
  3. 27 May: 17.4 - admitted immediately to hospital for 2 days  (phototherapy + on ebm and similac formula alternatively)
  4. 28 May: 9.9 - not low enough to be discharged
  5. 29 May: 9.2 - discharged but need to do another test next week

I reckon it's daddy's blood group (O+) that is causing this base on the following observations:

  • yx's blood group which is the same as mine (A+) did not have jaundice, neither did myself nor my bro who is also in the same blood group.
  • My elder niece who has the same blood group as her dad (ie. my hub's bro) also suffered the same.
Then again, the above observations does not fit into the "Risk Factors for Pathologic Jaundice"

Doc suspect is "breast milk jaundice" since:
  • he is on total breastfeeding 
  • he is not a pre-term baby 
There is a third type of jaundice called late-onset, or breastmilk jaundice. This type of jaundice shows up during the second week of life, and peaks around the tenth day or later. It affects a very small percentage of infants (between 2% and 3%, depending on how you define ” jaundiced” – usually a level of 5-10mg/dl). The bilirubin count can remain elevated for weeks or even months, but will eventually level out at adult levels of 1mg/dl. The diagnosis is usually made in a healthy, thriving infant, and only after all the pathologic causes of jaundice have been ruled out. Often, this type of jaundice runs in families, and breastfed siblings are likely to be jaundiced as well. No one is sure why this type of jaundice occurs, but there seems to be something in some mother’s milk that increases the reabsorption of bilirubin, or decreases the liver processing of bilirubin. When the baby is temporarily given formula, either as a substitute for, or along with mother’s milk, the levels drop quickly, rising again as the baby returns to total breastfeeding. Even though we are not sure of the cause, what is important to remember in cases of late-onset jaundice is that the baby is not harmed in any way by continued breastfeeding. There has never been a case of kernicterus associated with this type of jaundice, or any detrimental after effects. Because we know the well-documented benefits of breastfeeding, the baby should not be denied the advantages of human milk, given the fact that the slightly elevated bilirubin levels will soon return to normal levels without any intervention. Once pathologic causes are ruled out, nursing should continue. Sometimes babies are taken off the breast for 24-48 hours just to make the diagnosis of breast-milk jaundice, though this is seldom necessary. If your health care provider wants to go this route, and the levels drop significantly, then breastfeeding should be resumed.- Source: link
So my guess is somehow right - perhaps due to the blood that runs in my hub's family, the blood is resisting some substance in the breastmilk that prevents bilirubin from breaking down. 

Ok, anything bad = dad's the cause; anything good = mum's the hero! =D

What we are doing now to reduce jaundice level:
  1. Doc's instructions - sun baby 9am and 5pm daily, 10 mins per session (to cover baby's eyes with handkerchief or the special eye band from hospital)
  2. Traditional method (by confinement lady and mil) - bathe baby with ng kee ( available in medicated halls) twice a day
Hopefully everything goes well. I can't wait for next Tuesday to know the jaundice level. Confinement lady said he looks better now, but I need some proof from the doc. urgh. 

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