Jaundice

After Nathan was born, we were told that he couldn’t go home immediately because he was diagnosed with jaundice.  Jaundice is a condition where the baby’s skin (and the whites of his eye) take on a yellowish tint due to his body’s inability to clear out the bilirubin (I’ll get to that in a second) in his body.  Now, apparently this is not uncommon and the doctors and nurses took it to be pretty routine stuff, but still, we were a little freaked out.  Sure we had heard about it in our pre-natal classes and we had read about in books and online, but still, our kid “had a condition”, so we naturally felt very concerned.  Well it turned out that we actually had to come back the first week after his birth because his bilirubin count still had not gone down and he had to spend a night in the Neonatal ICU under a biliblanket.  But after that Nathan’s jaundice cleared up and everything went back to normal…for a bit.

So what is this thing called jaundice?  Well, it’s basically a situation where the breakdown products of red blood cells – called bilirubin – build up in your blood because your liver can’t clear it out fast enough.  It’s a condition that occurs to a great number of babies – I’ve read and heard of numbers ranging from 25-50% of all newborns.  Adults jaundice can be indicative of other reasons – some serious – but for babies, its not unexpected since their organs still haven’t quite gotten up to gear yet and the liver hasn’t quite rev’ed up to clear out all the blood breakdown products that could’ve accumulated from the womb as well as the birth itself.  For Nathan, he was a vacuum extract baby, so that means that he had to have a suction cup basically grab onto his head when he was still in the womb and the doctors used that help him come down the birth canal and out of his mother.  This is a rather traumatic event and it also leaves a bruise on his head, just under his skin where the suction cup had grabbed onto his scalp and pulled.  So that meant that Nathan’s body has to get rid of the normal byproducts of being in the womb, but also this additional blood breakdown arising from the contusion on his head.

When the doctors first checked him, they used some kind of a handheld gizmo to shine a light on his skin and determine his level of bilirubin.  It’s called a transcutaneous bilirubinmeter (if you see this and throw the technobabble around, the hospital staff may be impressed with you).  Nathan was just below the threshold so we stayed a couple of extra nights at the hospital and went home after three days when his level seemed to be dropping.  We went back after 24 hours and they measured him again, and his bilirubin levels had actually gone up.  That wasn’t good, so the pediatrician we saw at the time ordered a night of bilirubin treatment for Nathan.  It’s not good because prolonged high bilirubin levels could lead to some brain development issues (according to the web).  In addition, the slowness with which his body was clearing the bilirubin was indicative of something else – something we learned later was called pyloric stenosis (I’ll talk about this in more detail in a later post).  In a nutshell, it meant his body wasn’t taking in enough nutrients and growing fast enough.

Well, we checked into the NICU and stayed the night.  That was one rough night.  A biliblanket is essentially a phototherapy device – literally a blanket that is impregnated with multiple light sources that outputs blue/white light so that Nathan’s skin can absorb it and this assist with the break down of the bilirubin.  It sort of looks like this:

Of course, our little bundle of joy had to be stripped naked so to maximize the absorption of the light by his body.  But did I mention that Nathan hates being cold?  Yeah, he was pretty sensitive the cold then, and being stripped naked in an air conditioned hospital room did not make him happy.  And he had to get this all night.  And he had to have his bilirubin levels verified with a blood test – which meant a painful blood draw from his foot.  He was not a happy camper.  Oh, and because the light is intense, his eyes had to be covered by a cover that looked like this:

These actually aren’t pictures of Nathan – to be honest, we were too harried and tired to think about taking pictures.  I found these online.

Let me tell you that this eye goggle thing is a terrible design.  It’s basically a sponge attached by a velcro that wraps around the head.  Nathan is a squirmy child and he hated having that thing on his head.  Which meant that Susan and I had to stay up all night to make sure that the goggle didn’t slip and come off of his head, lest his eyes be damaged by the light.  Well, Susan and I tried to take turns sleeping and watching over the kid – all night.  And this is after a sleepless night the previous night.  But in reality we just stayed up the whole night, each helping to keep the other up.  Oh, you better believe we’re going to remind Nathan of this when he grows up.

Eventually the following morning, after 3-4 blood draws to confirm the dropping bilirubin level, the pediatrician determined that Nathan’s jaundice level had come down and that he could go home.  The remaining jaundice his body could take care of by itself.  And none too soon – both Susan and I were ready to drop from exhaustion.