[Learning points]
  1. Learn how to observe the signs of jaundice and when to seek medical attention: seek medical attention immediately if you are weak, sleepy, have weakened sucking power, vomit, do not drink milk, and the skin color of the back of the palms and soles of the feet is as yellow as the face.
  2. Understand stool card observation: use stool cards to identify numbers 1-6 as abnormal color cards and numbers 7-9 as normal color cards.

Ⅰ、What is the neonatal jaundice? 
The product of metabolism of red blood cells in human blood, one of which is called “bilirubin,” which is finally excreted through the liver. Newborn red blood cells are more common than adults (thus, more red blood cell metabolites are produced), and the liver is less mature (thus, bilirubin is not easily excreted). Therefore, bilirubin will accumulate in the body, causing yellowing of the skin and whites of the eyes. It knowns as the “Neonatal Jaundice”.
 
Ⅱ、How neonatal jaundice distinguishes between physiological and pathological
Physiological jaundice Pathological jaundice
It occurs in 2-3 days after birth, reaches the peak at the 4-5 day and restored to normal range in 7-10 days. The bilirubin excretion can be promoted by feeding enough breast milk to subside naturally or by light therapy to reduce jaundice. It usually occurs within 24 hours after birth, and may last for more than two weeks. In severe cases, it may even cause bilirubin to pass through the cerebrovascular barrier and cause brain damage. The causes include incompatibility between mother and child blood type, broad bean disease, biliary atresia, infection, etc.
 
Ⅲ、When to seek medical immediately
If you find that the back of baby’s palms and feet become as yellow as his face, weakness, drowsiness, sucking weakness, vomiting, not to drinking milk. In more serious situations, baby will hard to pacify, sharp cry, stiff limbs, and seizure. Seek medical advice as soon as possible and have a doctor perform a detailed examination. After hospitalization, it is usually need to receive phototherapy, and a few of babies with severe jaundice need blood exchange therapy.
 
Ⅳ、Home care
  1. Have your baby drink enough milk (pre- dominantly breast milk recommended). After three days of birth, have at least six to eight wet and light-yellow urine diapers a day.
  2. Whether it is breast-feeding or feeding formula milk, because the milk itself contains water, so there is no need to feed water. In addition, other diets are not recommended for babies.
  3. Observe baby's jaundice in a well-lit place. If you find the back of baby's palms and feet become as yellow as his face, drowsiness, vomiting, gray stools (fig. 1), fever, etc., seek medical immediately.
    Abnormal 536562ce0db8d36b5cc7318480cab308.png ea4809e1231f273fef85ed0595843cac.png 25e41e15a4d1bb7a9e4e79367be4c90f.png
    ab75cb7b25e8dddd0ead7ab7f29ab7a5.png 6fac77993de8cc0037169ad4d492afe7.png 5c145bf5f1807b86d27ef966b3ab7a68.png
    Normal 56a2d6868bcea6f42a55c5b4a1d1250d.png 758f952d3377f595d298834630081c8a.png b375a66c0647913b88f3c4dd7c393c18.png
    Figure 1. Stool identification card
  4. Exposure of the baby to sunlight or general fluorescent lighting does not improve jaundice, and if you do not protect your baby's eyes, you may cause eye injury.
     
Ⅴ、Conclusion
Neonatal jaundice is a common phenomenon and many parents are concerned. After returning home, close observation of the baby’s jaundice will help early detection and medical treatment to prevent the occurrence of complications.
 
Ⅵ、References
  1. Huang, J.W., & Lin,Y.H. (2019). Nursing of high-risk neonates. Chen, Y. Z. Lueckenotte (Ed.), Practical Pediatric Nursing (8nd ed., pp. 147-159). Taipei City: Hua Xing.
  2. Wang Xinhua(2021). The baby is yellow, the new breast feeding panic- Recognize neonatal jaundice. Chi Mei Medical Information,(132),21-22。
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    位置
    資料夾名稱
    English
    發表人
    李佳緣
    單位
    中榮護理衛教
    英文名稱
    Neonatal Jaundice
    分類
    出院照護
    科別
    英語
    癌症照護
    建立
    2024-02-25 10:00:42
    制訂日期
    2017-06-07
    最近修訂
    2024-05-15 16:16:00
    版本
    2024-05-15
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