Neonatal Jaundice: My Experience With Baby Arissa

What is Neonatal Jaundice? 

Neonatal Jaundice (NNJ) or neonatal hyperbilirubinaemia is one of the most common medical conditions in newborn babies.

Just like the definition itself, this is the most common medical conditions in newborn babies, hence Arissa was also one of those who had jaundice. When we were at Pantai Hospital KL, her levels were not that high and doctor told us that there was no need to perform phototherapy and we were discharged on the 3rd day.

My husband then registered Arissa’s birth with Klinik Kesihatan Puchong Batu 14 and the nurses came to our house to check on Arissa and I on our 3rd day back at home. They did a visual assessment (“check Kuning”) on Arissa and told us that we need to go back to Klinik Kesihatan to check her bilirubin level.

Visual Assessment of Neonatal Jaundice (Kramer’s rule)
Visual Assessment of Neonatal Jaundice (Kramer’s rule)

 

The weeks after that were like HELL to me

We went to Klinik Kesihatan (KK) to have Arissa’s bilirubin level checked, the process in KK is simple but the waiting time really depends on your luck. If that day happens to be a busy day, you can wait for hours but if you are lucky, you are done within an hour. So the process is something like this:

  1. Place your pink book (if you’re a girl, blue for boy) at the counter so that they can give you a number (wait time: 5-10mins)
  2. Put your pink book in front of the room where they will take your blood sample and wait for your turn (wait time can be as fast as 10mins or as long as 1 hour) *they do try to give express service for babies but it still depends on the number of babies that visit KK that day
  3. Take the blood sample to the Lab and wait for results. The results are instant. (wait time: 5-15mins)
  4. Take your pink book (where they have written the results of the bilirubin level) to the doctor’s room and wait for your turn (wait time: 10 mins to 1 hour)
  5. For jaundice, the doctor usually will look at the bilirubin level and advice you accordingly. They have this standard requirements where a baby would need to repeat the test (every 2 days) until the total serum bilirubin level is 5 and below. Otherwise, they will refer your baby to the hospital to perform further tests.

For Arissa’s case, her reading was low but not low enough and I had to go back to KK again and again to have her blood taken to check for bilirubin level. My heart aches every time they prick her little foot to get blood. And for the 2 weeks that we are going to KK to check on Arissa’s jaundice level, I had so many people telling me what to do and what not to do and what is best for Arissa and it was seriously taking a toll on me. I believe that if you are not a parent, you will not understand why I feel so stressed-up. Only another parent will better relate to my feelings. Some of the comments that I received:

  • Feed Arissa with grape juice, chestnut juice and water as this will help her poo poo and her jaundice level will go down
  • Sun bathe Arissa – make sure it is the morning sunlight (7am to 10am) for about 20 minutes
  • Stop breastfeeding as it is your breastmilk that is causing the jaundice
  • Stop eating heaty food – no ginger, no confinement food, no herbs with roots
  • Bathe Arissa in boiled ladyfingers’ water or Guinness stout

Really, the list is endless and seriously the worse was asking me to stop breastfeeding. In the end, we did the sun-bathing but it didn’t work. I stopped eating ginger or herbs in my confinement food and it didn’t work either. To be honest, I later on read up on all the above, feeding the grape juice or chestnut juice is to make your baby purge because at early stage of jaundice, the poo color should change from black to light brown. So, only if your baby’s poo has not turned color, you may try those juice, otherwise please don’t as there were cases where the baby had diarrhea and had to be hospitalized. Not too sure if bathing them in Guinness water or lady finger’s water will make any difference.

Whatever it is, most importantly is “Please make sure you do not stop breastfeeding! ”

Breastfeeding, because of its benefits, should be continued in the jaundiced babies.  Adequate lactation/breastfeeding support should be provided to all mothers, particularly those with preterm babies. In breastfed babies with jaundice associated with inadequate intake, excessive weight loss or dehydration, supplementation with expressed breast milk or formula may be considered.

Source: Ministry of Health Malaysia

In the end, as Arissa’s jaundice level was still above 5 after more than 14 days, KK referred us to Putrajaya Hospital for further tests. They suspected that it may be prolonged jaundice but also wanted us to make sure there was no complications or other issues. So, we went to Putrajaya Hospital and Arissa had to go through another round of blood test and urine test.

Putrajaya Hospital – Prolonged Jaundice. They will take blood and urine sample to test for thyroid, heart and liver to make sure there were no complications or other issues.

If you notice, No. 7 also mentioned that breastfeeding should continue when baby has prolonged jaundice. The doctor that consulted us later told us that usually there is nothing to worry if it is prolonged jaundice as it will eventually go away.

After that, I started eating proper confinement food! I told my confinement lady to bring on the ginger food, pork knuckle boiled in black vinegar sauce and whatever herbal stuff that one should eat during confinement. I only had around 1 week left before she leaves!

All mommies out there, do not worry if your baby has prolonged jaundice, do not get stressed with all the old folk’s tale or advice that random people tells you, just take it easy and stay calm.

The Pink Book from Klinik Kesihatan
Blood specimen to be taken to the lab to test for bilirubin level
The number of times that I have to go back to KK  during the 1st month after my baby is born. She started with total serum bilirubin of 10.1mg and lowerst was 7mg and it went back up to 7.6mg.
Arissa with mom and dad at 1 month old. She is sleeping so soundly.
At this stage, Arissa still has slight jaundice due to prolonged jaundice also known as breastmilk jaundice. However, I did not stop breastfeeding as advised by the doctors and her jaundice went away eventually.
Arissa at 1 month old, looking like a ballerina.
Arissa at 1 month old, looking like a ballerina.

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