Wednesday, July 6, 2011

Jaundice: The Color of Kernicterus

I never got to hold him --my day was too busy-- but I did get to pray for him. And as I lay my hand on his chest to pray, his gaped-jaw expression and labored breathing jarred me.

Would he live?

By the time I saw him, Dennis and Margaret had already completed a Ballard’s score on his tiny frame. A Ballard’s score helps determine how old the newborn is in terms of weeks. This is particularly useful when the child is preterm, like he was. He was roughly 32 weeks gestation.

His parents said he was born 4 days earlier but refused to breastfeed. Margaret was able to help his mother manually express, then fed him with a syringe --the first time in four days!  But ultimately it made no difference.

He died.

I’m told his mother came once for prenatal care. She delivered prematurely at home and then for four full days stayed there watching her child become progressively weaker and yellow.

Did she not know we could help?

However by the time she came, there was little we could do. He was lethargic, dehydrated and yellow. Pathological jaundice --or possibly Kernicterus-- had already set in.

For those who don’t know, jaundice is caused by the build up of the levels of unconjugated bilirubin in the blood.

It is more common in preterm babies and was perhaps caused or compounded by the fact she was not able to breastfeed. Treatment for it is helping to establish breastfeeding and exposing the baby to sunlight (or bilirubin lights).

When bilirubin levels are high for too long, it leads to Kernicterus which is when bilirubin is deposited in the brain, causing brain damage.

Had he lived, he would have been severely brain damaged.

Please pray for the family that lost this precious child. Pray also I’m able to teach these women about breastfeeding better. Frankly, I don’t know where to start on this one. Thanks.