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Q. What are the causes of jaundice in a newborn ?

A - A newborn can have 2 types of jaundice
        (1) Physiological jaundice.
        (2) Pathological jaundice.

Physiological jaundice : This occurs on the 2nd or 3rd day from birth and starts diminishing when the baby is a week or 10 days old. The reason for this to occur is due to the liver being immature to deal with the excessive billirubin formed because of the normal breakdown of the oxygen carrying red blood cells. In the premature infants it is likely to be more severe.

While physiological jaundice usually does not require any treatment, but more severe cases are treated effectively with phototherapy under an ultraviolet lamp often called a bili – light.

Pathological jaundice : This is extremely uncommon and is present at birth and develops rapidly during the 1st day of life. It indicates haemolytic disease caused by blood group incompatibility (as when the baby has a different Rh factor from the mother). The other causes of pathological jaundice are obstruction in the liver, blood or liver diseases, intra uterine and neonatal infection.
The treatment will depend upon the cause and may include phototherapy, exchange blood transfusion or surgery to remove obstruction.

Q.  What care should you take for the umbilical stump ?

A – The last remnant of a baby’s close attachment to its mother in the uterus is the stump or the umbilical stump. It turns black a few days after birth and can be expected to drop off anywhere between one and four weeks later. You can hasten healing and prevent infection by keeping the area dry and exposed to air.

The following will help accomplish this:

1. Avoid urine to touch the umbilical stump cord.
2. Skip tub bathing and avoid wetting the navel while giving a sponge.
3. Dab the stump with alcohol.

Q.  Hiccups in Newborn

The  baby’s  hiccups  are believed to be another of baby’s reflexes. Some babies are not just born hiccupers, they are hiccupers even in their mother’s womb. The  chances are that if your baby hicupped a lot in the womb, he will  hiccup  plenty in the first few months after birth too. The new  baby’s hiccups   dont  have a  known  cure  unlike the adult variety,though they frequently triggered by giggling later on. And also unlike the adult hiccups, they   are  not  bothersome , at least not  to the  baby. If   they  are  to  you, try letting your baby nurse or suck on a bottle which may quell the attack.


Q.  Eye discharge in new born

In nearly about 1 out of 5 new babies, a chemical conjunctivitis is seen. This is because silver nitrate drops are instilled into the newborn eyes to prevent a gonococcal infection. This   conjunctivitis is charactered by swelling and a yellowish discharge that disappears by the 4th or 5th day. Many hospitals now prefer to use antibiotic ointment or drops which are less likely to trigger an adverse reaction.
If the swelling and discharge do not clear up, or if conjunctivitis begins any time after the first 24 hrs, an infection should be suspected and a doctor be consulted. Tearing, swelling or infection that begins once you are home from the hospital can also be due to a blocked tear duct.


Q.  My baby has a coating of white curd in the mouth, and if I try to brush away, the mouth bleeds.
A.    The white coating in the mouth of the baby is commonly called Thrush.

Thrush is a fungal infection ( monilial infection ) which it acquires from the vaginal canal of the mother during birth. The causitive organism is Candinda Albicas, which is a normal inhabitant of the mouth and vagina. Normally it is kept in check by other microorganisms and it usually does not cause problems. But due to to  certain illness, or intake of antibiotics or hormonal changes, there is a upset in the hormone balance and the conditions become favourable for the fungus to grow and cause symptons of infection.
Thrush appears in elevated white patches that look like cottage  cheese or milk curds on the inside of babies cheeks and sometimes on the tongue, roof of the mouth and gums. If the patches are wiped, a red raw area is exposed and there may be bleeding. Thrush is most common in newborns, but occasionally an older baby taking antibiotics will be infected. The yeast infection itself is not dangerous, but it is painful and can interfere with the baby's feeding. A doctor should be called if one suspects thrush infection.


Q. My son is born with undescended testicles. Is there any cause for worry ?
A. The testicles  in the  males and the ovaries in the females babies develop in the foetal  abdomen from  the   same embroynic tissue. By the 8th month of gestation, the testicles descend to the scrotum sac at the base of penis. But in 3-4% of the full term babies and 1/3 of the pre-term babies, the testicles  do not  descend  and the result is undescended   testicles. The  diagnosis of  undescended   testicles  is made  only  when  one  or  both the testicles are not observed in the scrotum, even  when  the  body  is   in  a  warm bath. An undescended testicle  causes  no   pain  or  any  difficulty  in  urination. Normally undescended testicles descend in the scrotum  on its  own by the age of 1 year. In  rare cases, 3-4  boys  out  of a 1000  may  persist to have  the  testicles , and  then  surgery  is  recommended   which  is successful.