Text transcript of video

MUSIC BEGINS.

VIDEO TITLE: Jaundice and Your Newborn
What every parent should know

MUSIC ENDS.

LAUREN: Did you know that jaundice can sometimes lead to brain damage in newborns?

JIM: What my wife just told you is really important for every new parent to know. It’s so important you should probably hear it again. If babies don’t get the right treatment when they need it, jaundice can hurt them, and can even lead to brain damage.

JIM: Now we’re talking about this, as parents, so you know what you need to do to keep your baby safe and healthy. Because getting hurt by jaundice is preventable.

LAUREN: Most babies get jaundice, and most of them will be just fine – like our son. He had jaundice – but today he’s a healthy 4-month-old because we knew it was something we needed to take seriously. We talked with our doctor and we all worked together to make sure we stayed on top of it.

JIM: It’s really not complicated; there’s three main things to learn about jaundice so you understand the facts. Know if your baby’s at risk for problems with jaundice. Ask about a jaundice bilirubin test for your baby before you go home from the hospital. And make a follow-up doctor’s appointment for your baby that’s within 48 hours after you take your baby home from the hospital. And be sure to go.

LAUREN: This video will go through each of these areas. But if you want to know more, there’s plenty of information your doctor or nurse can give you. Ask questions! This is your baby. What could be more important?

DR. ARTHUR SHEPARD: Parents are a very important part of the team approach to managing jaundice. When parents are thinking about the delivery of their new baby, it’s important for them to think about three things. First of all, know if your baby is at risk for jaundice. Second, ask your baby’s doctor or nurse if a test for jaundice or bilirubin can be done. And third, make sure that your doctor arranges for you to be seen within 48 hours of discharge.

LAUREN: Most babies with jaundice can be treated just by increasing the amount of milk they drink. But some babies with jaundice will need treatment, which usually means lying under special blue lights for a day or two. Putting your baby in the sun is not a safe way to treat jaundice.

JIM: So what is jaundice? Most people think about jaundice as yellow skin and eyes. That yellowing is caused by a buildup of bilirubin.

LAUREN: A little isn’t so bad, a lot can be toxic. And if it’s not treated in time it can sometimes lead to a whole range of problems from hearing loss to brain damage, called Kernicterus.

KAREN DIXON: My son and other children with kernicterus face incredible challenges every day. Tasks that I take for granted, um, such as getting a glass of water, writing my name, fastening a button, are nearly impossible for most kids with kernicterus. Many children with kernicterus are unable to talk, they’re unable to walk, they have hearing impairment. So, everyday is very difficult for them.

DR. ARTHUR SHEPARD: Jaundice is a term that we use to describe the yellow coloration of the baby’s skin and the whites of the baby’s eyes. The more technical term that clinicians use to talk about jaundice is hyperbilirubinemia, which just means elevated levels of bilirubin. At mild to moderate levels, there’s really not very much danger to the baby. But if the bilirubin accumulates in very high levels, then it can be very toxic to the baby’s central nervous system. Jaundice is a normal problem that affects normal newborns.

LAUREN: So those are the facts – jaundice and hyperbilirubinemia are really common and can be serious, but it’s treatable.

JIM: Now, some babies have a higher risk of running into problems. In our case we had three things going on that made us extra careful.

LAUREN: First, our son was born 2 weeks before his due date. I was also having some trouble with breastfeeding, so our son was not getting enough milk and he was getting dehydrated.

JIM: On top of that our son was bruised during delivery, which can add to the jaundice.

ANN SCHWOEBEL: Blood group incompatibility, where mom has O type, or an Rh negative factor, which would lead to an increase in bilirubin because of the break down of the red blood cells. It’s very important for parents to get a handle on some of those risk factors ahead of time. One of the big things that the nurse in the hospital can do, is help you with breastfeeding. It’s a learning process for the mom, and it’s a learning process also for the baby. Breastfeeding is best for your baby. It offers your baby the most optimal nutrition that you can give to your baby. So all those things can be done ahead of time to prevent any jaundice issues.

LAUREN: For people with darker skin, like us, it’s especially hard to know if a person is jaundiced just by looking.

JIM: That’s why you really have to ask your doctor or nurse about a jaundice bilirubin test before you bring your baby home from the hospital. A jaundice bilirubin test is the safest way to accurately measure the level of risk. And that’s a fact.

DR. ARTHUR SHEPARD: Without any question, all babies should be evaluated prior to discharge from the hospital, for risk factors that would be associated with high levels of bilirubin. The American Academy of Pediatrics has provided us with very clear guidelines regarding follow-up. Ah, the Academy has suggested that all babies should be evaluated within 48 hours after discharge to see whether or not jaundice has become a problem since they’ve left the hospital.

In the past, many people used to try to estimate bilirubin levels just by visually assessing the baby. And what we found over time was that was not very accurate. We’ve come to the point where we rely on clinical tests to help us with that decision. There are two options.

One of the options is what we call transcutaneous bilirubin testing. And in that case, a very sensitive light meter is placed on the baby’s skin, and can determine what the level of bilirubin is in the baby’s blood stream. If a transcutaneous bilirubin monitor isn’t available, then clinicians can collect a small sample of blood, send that to the laboratory, and that sample of blood can be tested for a bilirubin level.

With routine screening and good follow-up, there’s no reason that any baby has to suffer the long-term consequences of high levels of bilirubin.

KAREN DIXON: I never knew that newborn jaundice could cause brain damage until it was too late. In the event that your doctor or nurse doesn’t talk about the jaundice bilirubin test with you, ask them about it. And if you have concerns about your baby’s jaundice, ask for the test cause that’s the best way to know for sure his level of risk.

JIM: Once the test results are in, the doctor uses a chart called a nomogram to help them figure out if the baby’s at risk.

DR. ARTHUR SHEPARD: On the nomogram, risk is predicted in one of four categories, A, B, C, and D. So we can tell if a baby is in a low risk category, or high to moderate risk category, or perhaps, in a very high risk category and actually need immediate phototherapy after receiving the results of their bilirubin screening. Other babies would be in a category where continued follow-up is more appropriate than immediate phototherapy.

LAUREN: Our son was tested in the hospital and was in the 95th percentile – the red zone – and he needed treatment.

JIM: He had to stay over at the hospital to be treated with the lights. The next day they tested him again and he was okay to go home.

JIM: But levels of bilirubin don’t peak until at least 3 days after babies are born, and you’ll probably be going home before then.

LAUREN: That’s why it’s very important to make sure your baby has a checkup within 48 hours after you take your baby home from the hospital - even if they were tested in the hospital.

LAUREN: When you’re just home from the hospital with your baby and you haven’t slept much at all, the last thing you probably want to do is take them to the doctor’s. But you really need to go to that appointment.

JIM: In the meantime, you need to keep an eye out for the warning signs.

ANN SCHWOEBEL: If a baby is crying inconsolable, or the baby is limp or very stiff, or very floppy. Those are changes, if you haven’t seen them in the hospital. Those are changes that you want to call the physician.

KAREN DIXON: If you see that your baby is not waking up to feed, if your baby is having a hard time staying latched on. If their neck and back is arching, if you hear a very high pitched, or shrill scream, go to the emergency room. Don’t wait. Your baby needs medical attention.

LAUREN: Those are all signs that jaundice could become a serious problem. If you see them, don’t wait for your appointment. Trust your instincts. Go to your doctor’s and get them checked right away.

DR. ARTHUR SHEPARD: When new parents take a baby home from the hospital, it’s important that they remember three main points about jaundice. First of all, know if your baby is at risk for jaundice. Second, ask your baby’s doctor or nurse if a jaundice or bilirubin test has been done. And finally, make sure that your baby has a follow-up appointment scheduled for 48 hours after discharge.

MUSIC BEGINS.

LAUREN: Being pregnant, having a baby, it’s an amazing experience. For us, learning the facts about jaundice helped us know when to take action and worry a little bit less. Every parent should know about jaundice.

JIM: Nothing is more important to us than the health and safety of our baby. Nothing.

FADE TO BLACK.

VIDEO GRAPHIC: Know the facts about jaundice:

Know if your baby is at risk

Ask your doctor or nurse about a jaundice bilirubin test

Make a follow-up appointment - and go

CREDITS

END.
 

Date: November 8, 2005
Content source: National Center on Birth Defects and Developmental Disabilities