Jaundice = too much bilirubin from RBC breakdown
by Dawn Devor
1. CAUSES
1.1. Hemolytic Disease (RH-, or O blood types), this is the Main cause of jaundice.
1.2. Oxytocin Augmentation from the induction of labor
1.3. Breast Milk - Bilirubin increases when breast milk comes in and develops after the 1st 4-7 days of life.
1.4. Breastfeeding - If mom is dehydrated or baby is not getting enough calories through breastfeeding, then jaundice can set in.
1.5. Inadequate Liver Function
2. TREATMENT
2.1. Phototherapy
2.2. Exchange Transfusion - the replacement of damaged blood with new blood.
2.3. Fiber Optic Blanket - A blanket that encorporates and encompasses photherapy lights. Care & feeding is much more accessible with the use of the blanket & goggles are not required.
2.4. Treat underlying infection
2.5. re: Breast Milk - discontinue breast feedings for 1-2 days until bilirubin levels come down then may resume.
3. Risks
3.1. Major
3.1.1. Infection
3.1.2. Previous sibling Hx.
3.1.3. undiagnosed blood type
3.1.4. excessive weight loss
3.1.5. East Asian or Mediterranean descent
3.1.6. GA 35-36 wks.
3.2. Minor
3.2.1. male babies are at greater risk
3.2.2. Macrosomia born to a diabetic mother
3.2.3. maternal age > or = 25
3.2.4. GA 37-38 wks.
4. Nursing Interventions
4.1. Labs
4.1.1. direct bilirubin
4.1.2. indirect bilirubin
4.1.3. RBC count
4.1.4. coombs
4.1.5. determine Blood Type & RH factor