Hey guys, my baby's bilirubin reading just hit an all time high of 262 (prolonged jaundice btw). So, the KK gave me a referral letter to go to the hospital for further actions to be taken. So i went to Putrajaya hosp on the same day, hoping to get phototherapy for my baby, and to my horror, the nurse at the pediatric counter told me that she would give me a scheduled consultation for next wednesday! After being stunned a little, i asked her can it wait that long?! She replied that my baby is only 17 days old and they only look after babies who are 21 days and/or older. WTF?!

What should i do? i'm considering going to a private hospital now as i worry if i wait for wednesday it'll be too late and the bilirubin levels might increase some more. Any suggestions? should i wait? So worried!

Hi there. Is your baby having a direct BF? It's the best of the best cure that I know.

If not, try to go to other GH. Serdang is near to you. I dont know bout policy of taking babies >21 days. Isn't babies younger than that needs extra care??

262 is really high yo..

it's going to cost a lot of money
try other hosp like KL general hosp.

Tiap2 morning get ur baby under the sun lo..preferable at 7am.

keep the baby cool at all time (heat/high temp will only worsen the condition)..ensure the baby is fed well, ideally breastfeeding. however, if doing bf, the mother must avoid eating anything spicy, no chillis, no blackpepper, no herbal remedies, no makjun or whateva (all the typical "heaty" things)..these stuff willl again makes things worse

My son once warded at kpj damansara for jaundice, after 2 day can discharged. They put him on "speedboat" during the UV session. Cost around RM 1100++ on 2014.

If you can afford it, go private hospice to ease your concern.

get the baby to drink more. breast milk preferable. alternate with water

get the baby to drink more. breast milk preferable. alternate with water
Best is to get to doctor but my experience with 2 kids doctor advise as above as to dilute and get them excreted via urine

My baby boy recently admitted to NICU hosp selayang after TSB reached 253, 6 days old,KK provide referral letter went straight to emergency then NICU, phototherapy for 2 days and discharge,but now day 21 still tsb level not normal,around 170,got another appointment with hosp selayang next week..u can google about home phototherapy, rent the machine and do it on ur own at ur house

Is this your 1st child ?

My son had jaundice too when he was born. Took him to KK and KK said to go to GH. His reading was 250 ~ 300. Brought him to GH (admitted for 2 nights) and they put him under phototherapy until the reading went down to less than 250. He was then discharged but a few days later I brought him to KK and his reading was back up to more than 250 again. KK said to go to GH again but I just felt that it wasn't convenient to sit there just to be placed under phototherapy. I asked around and found out some private clinic in Seremban have the machine and it's either you rent the machine or stay there. I rented the machine and put him under the light at home for 3 days. His reading when down to less than 200. In between everyday I brought him outside under the morning sun around 8 ~ 9am. His reading then slowly went down until the jaundice went away.

If I were you, I wouldn't wait that long as you need to bring down the reading to at least under 250. I'm seriously not aware of such policy and never even knew such policy exist in the 1st place. My son was admitted to GH when he was less than 2 weeks old so I don't know why Putrajaya Hospital has made it such.

My advice is, don't wait too long. If possible BF your baby as frequent as possible as it helps to clear the jaundice. Also, try to put your baby under the sun every morning but don't do it after 9am as it gets quite hot. 8~9am should be good. It's better to go to a private hospital and put your baby under phototherapy.

found this : Jaundice threshold table

>350 only start phototherapy?!

anyways, my baby has been consuming breast milk exclusively, 3 ounces every 2.5-3 hrs.

i think i'll bring her to private hosp just to be safe.

thanks for the replies everyone!

Put yr baby under morning sunlight and cover eyes with towel while you plan to bring to private hospital

dude..monitor the mother's food intake too...refrain from all those food or medications that could worsen the jaundice

There is also something call breastfeeding jaundice. Try google and see

Place your baby in the sun for 10-15 min in the morning. Please cover her eyes.

In the meantime, bring her to KK again for checking jaundice level to ensure it does reduce and let the nurse know that hospital is not accepting the case. Probably they can do something.

Ensure your baby eat a lot in order to detox more.

yes, i read about it and it is known to be not serious. but i can never be too sure if it is indeed caused by breastfeeding and that the bili levels subside.

Also i forgot to mention, my wife has been avoiding ginger and alcohol intake in the food she consumes. Baby's stool color seems to be mustard color, not pale. Baby feeding fine and regularly. So i guess there's no obvious symptoms of liver damage yet. Only thing alarming is the high bili level and the hosp not doing anything about it.

but yeah, i'll take her to KK in the morning to check on the lvls again, and if docs still dont issue an emergency letter to get photo treatment, i'll bring my baby to private hosp... worse comes to worst, rent the damn thing.

1. calm down.
2. is your child born term? if yes then day 17 old is prolonged jaundice for your child.
if that is the case, there's no real harm to jaundice except that the child looks yellow. there is NO risk for kernicterus for prolonged jaundice as the blood brain barrier is developed now, and thus there is NO need for phototherapy.

as long as it is only jaundice and not anything else like fever or unable to feed, it's fine.

This post has been edited by slimey: Jan 27 2016, 04:17 PM

always better safe then sorry.
yes, ginger will cause jaundice.
But do not stop BF because of this. if the doctor not alarming, then maybe this due to bf jaundice. nothing to too worry about. caused they can developed up to 30 days if not mistaken. Ask doctor to show you how to use finger to press on the baby face (forgot which part d, but can see the indication of the jaundice)

good luck

she was born at 38 weeks. is that considered normal?

yes. that's term.

our kids had jaundice too and was hospitalized for a few days but then
after not much improvement we self discharged him and did some traditional
practice and within the same number of days that he spent in the hospital
he was back to normal again

went back to the hospital to do checking that's what they are good for
scanning and checking but not healing, and they said whatever you did
just continue la he is ok already, we don't need to know what you did
goodbye

yup normal. no worries bro, jaundice is normal and as 1st time parents we tend to get a bit too panic at times.. haha

We didn't go to government clinic due to the attitude of the nurses that came to our house. Simply write on the paper said jaundice level at a high level. How they measure? just use eye see only ~ !

I think my baby jaundice goes away around 1 month plus naturally.

Yes. Use eye can see.

Estimate is quite accurate if child never exposed to phototherapy or sun light.
If jaundice up to head 50, up to neck 100, upper chest 150, upper abdomen 200 below belly button 250, hands and feet 300.

A lot depends on the age of the child.

Day 1 jaundice is always a big sign of problem and must be hospitalized.
Day 2-14 jaundice can be physiological or pathological. If no other sign other than jaundice, then the indication for phototherapy depends on the age of child, weight, blood type, any g6pd, and whether the child is term or not.
Day 14 and above is considered prolonged jaundice ( above day 21 for preterm child) and phototherapy is not required but need to investigate cause of prolonged jaundice( urinary tract infection, breast milk jaundice, hypothyroidism, etc). If all investigation is normal result, then conclude is breast milk jaundice which is not harmful and no treatment is required.

so r u suggesting i should stick to next wednesday's appointment?

I need to know the previous levels and days of life the level is at first to be on the safe side

Oh and if you don't mind, can pm me the referral letter to have a look also. I am curious why the doctor refer to hospital.

This post has been edited by slimey: Jan 27 2016, 07:01 PM

Rather refer in lyn; why not drop by medical center for 2nd opinion?

If you can afford; why not?

Once have diagnose; then only you choose where to treat.

My twins had prolong jaundice and they are born in putrajaya hospital. Both are breast feed. When to the hospital and same thing is advice to give as much breast milk as possible as that is one good natural cure. Every morning around 8am let them sun bath for 15 mins. It did take some time to get to normal but is all ok. If I remember correctly about 2 months before the jaundice completely gone

i brought her to pte hosp and the doctor there said i should wait for the wednesday appointment as her bili lvls were quite consistent and not at critical level yet. critical being above 300-350. so, i feel much relieved now. at least have a peace of mind.

may i ask. do you or your spouse are O blood type?

yes, me

FYI if one of the parent of a child that are O type blood, the child have the highest percentage having high jaundice level, if for normal parents that aren't O type blood, the jaundice will recover after a few weeks or by giving the child BF milk every 2 hours. that's why your son jaundice will only recover after a few month, i know this because my cousin husband is O type blood and their son jaundice only recover after 6 month, they have to go to the hospital often to take blood test, but don't worry, always BF your child, and always on the alert and follow the doctor advise because if your son jaundice doesn't reduce, your child might have to do blood transplant, that one thing u must worry....

Eem. Some corrections.

Blood type matters because of possibility of something called abo incompatibility. It can happen when mother blood group is o and baby blood group is not o. Anti-a and anti-b antigen from mother can be present in baby blood in such cases and can cause hemolysis in baby increasing the bilirubin level.
Anyway, this is usually a factor in the first week or so. Not in prolonged jaundice.
Exchange transfusion is not needed in prolonged jaundice also.

don't pandai pandai become doctor yourself la. if all of u so clever, people don need to spend 5 years to study. prolonged jaundice no urgency and no longer need phototherapy. just wait for ur appointment la.

all google doctors and wikipedia doctors. Cheers! may ur internet knowledge bless you.

just an update guys, my baby's blood test result is out and she is having breastmilk jaundice. Everything else is normal. Hospital said i no need to come back again for follow up or treatment. just go to KK monthly for the scheduled appointments (injections, etc..)

Anyone that his/her child jaundice level above 300? Mine is 338 today and im really worried about his recovery

There are 2 units used to measure bilirubin in the blood. im guessing its micromol/l.

Jaundice can be physiological and is really common among new born. Abnormal or not depends on the age of the baby and other risk factors.

There is a graph pediatrician use. Lower age have a lower threshold for abnormal. This may vary from center.

I cannot give further opinion or advise as causes are many. perhaps u could elaborate a lil more of ur situation?

http://d15gtop1hlgyun.cloudfront.net/conte...97/F2.large.jpg

Thanks for the graph, his age is 72 hours during check up. The eyes still not yellow yet, but the skin is yellowish. The baby still active when wake up, but sleep a lot.

I still do not know much to ascertain the cause or true severity. But as the bilirubin level is above the graph, its usually safer to provide phototherapy when in doubt.

A newborn arrives into our world and transition can be tough. Many of the body system struggle to cope in our world. Some babies may have shortness of breath for few days while others may have jaundice.

Physiological jaundice occurs as the babys red blood cells gets destroys faster than the body is able to discard them out. A Fetus(unborn baby) have high concentration of rbc to absorb oxygen from the mothers circulation. Once born many of these rbc are destroy but this time they cannot discard then via umbilical cord/mothers circulation. And they have to rely on their own system for disposal..

Sunlight helps break down bilirubin into a more pleasant form for discard while feeding further enhances the disposal from the body (bilirubin excreted into the gut and kidneys, infact they are responsible for the stool and urine colors). *do not intentionally put ur baby under the sun.. There is risk of sun burn.

However too much bilirubin can cause problem.. Mainly neurological damage. Hence pediatrician may give phototherapy and request the mother to stay in and give regular feeding as possible.. Even if there is not much milk, the sucking reflex does trigger bowel movement and helps dispose bilirubin via stool.

This post has been edited by FluffyTee: Aug 16 2016, 02:04 PM

Thanks for the advice, now still in phototherapy and feed by mother's milk regularly. 1st reading was 377, the doctor said its dangerous if reaching 385 and above. Today, drop to 264. Really glad about it, they are waiting it to drop below 240.

And from my reading, if a mother that have O type blood, and the father is not will have higher risk to get jaundice. In this case my wife is O and mine is B. There is 1 other patient same situation in the ward, the wife is O.

This post has been edited by omaigad: Aug 16 2016, 04:05 PM

That is among the common cause. The 2 common cause of hemolysis in fetus is ABO and Rhesus incompatibility. Rhesus is more severe.
Basically mother who is Blood O may have antibody agains A and B. As part of the immune system, the mothers body (group O) will identify the fetus as an intruder and attack them( blood group B or A). As a result the fetus loses alot of rbc. They are usually smaller in birth weight. Statistically they will turn out just fine should they survive till birth. But those severe cases may have still birth due to heart failure due to insufficient rbc.
The jaundice caused by these group are usually mild and babies wont have any long term abnormality. Severity of each subsequent pregnancy(if the baby blood group is unaccepted by the mother) is more severe than the last. But don worry, ABO incompat its usually just mild. Rh incompat is worst of all.

May i know how much does it cost if baby do phototherapy at private hospital like pantai?

I heard from my colleague his baby kena RM1000 over for 2 days photo-therapy in a private hospital in Penang a few months back.
If you have budget constraint, you might want to consider renting a phototherapy system at home. Google it and you should find businesses offering this. But make sure you notify your medical care provider.

I remember pediatrician always encourage newborn to feed frequently to alleviate jaundice when my sons were born few years back. I paid a few hundred ringgits back then for phototherapy as we got tired of frequent trips to Klinik Kesihatan.

I think its crazy to feed baby with breast milk during jaundice.

BREAST MILK IS THE CAUSE OF THE JAUNDICE!!!

Just remove breastmilk and feed with powder.

nope.

there's many reasons for jaundice............

breastmilk is a rare cause.

and breastmilk jaundice is harmless. to stop breast feeding because of breastfeeding jaundice cause more harm than good.

Just stop few days until it's ok. There is no harm.

those that stop a few days then ok is not breast milk jaundice.

duh.

and there's no harm to breast milk jaundice.........no reason to stop.

Stop few days of Breast milk and jaundice clear up is definitely Breast milk jaundice. Any jaundice is harmful. And almost all are Breast milk jaundice case due to bilirubin cannot clear.

nope.

jaundice is just yellow looking of the skin. the real harm is high level of bilirubin before the blood brain barrier is fully formed which is at day 14 for term babies. high level of bilirubin before day 14 can cause kernicterus. after that there's no harm in jaundice.

neonatal jaundice is caused by increased break down of fetal type red blood cell.
physiological neonatal jaundice can occur in about 40 percent of neonates. the jaundice in physiological jaundice hardly ever pass the point requiring phototherapy.
pathological jaundice occurs when there is infection or ABO antigen antibody incompatibility or Rhesus factor antibodies occur in the neonates. these can cause very high level of jaundice and usually occur very early in neonates.

so, if you stop breast feeding before day 14 how do you know if it is due to breast milk jaundice or not?

and breast milk jaundice never cause high level of bilirubin.

zero indication to stop breast feeding in a child with jaundice.

now stop spreading this ignorance and get educated.

Well, the bilirubin count is 200 before stopping and it drop to 100 after stopping.
If it's not the stopping then it's what? No phototheraphy after the stopping.

Don't tell me it's coincidental

Of course I am talking about before 14 days

This post has been edited by gogo2: Dec 30 2017, 09:03 PM

blablabla.

many reasons.

time.

baby liver can mature over time.

blablabla......

what's your indication for stopping breast feeding again????

Bilirubin exist in breast milk.

no it doesn't.

read more.

Well that's what I read. Either it has or if causes. Stopping a few days help. That's my experience. anyway it's over now. I guess u can try just stop a few days . No harm at all.

This post has been edited by gogo2: Dec 30 2017, 09:09 PM

then you read wrong.

no one will diagnose breast milk jaundice before day 14.

Well it works. so whether u wanna believe it or not, up to u.

Probably around 14 days. Give or take 1 or 2 days.

and so?

most jaundice clear on its own by that time.

take it or leave it.

Try having a baby, 7th day, went photo treatment...21 days later readmitted. Full breastmilk. Stopped on day 21-30. Continue after that. No more Jaundice. That's my son. He's 8 now. If you suspect Jaundice from breastmilk, no harm stopping a few days. My son was on bmilk all the way till 2.

Ok. Some say eating ginger cause jaundice.... LoL. That is more absurd...

My bAby same. Slimey dun believe I also cannot help him.

yes absurd indeed.
studies were done and found no correlation.

Well, people will always link color yellow or ginger to yellow of jaundice! I lol'ed.....

readmitted for what?

day 21 don't even require phototherapy.

Readmitted for Jaundice. Imagine how heartbroken we were.

This post has been edited by alucard_my: Dec 30 2017, 09:33 PM

If that is the case, just bring baby for blood test.

day 21 is prolonged jaundice.

no reason to readmit to hospital. kk should be able to carry out investigation.

I know. Skin dry up. Under hot light. Very sad thing to do to your baby.

Why investigate when you can solve by phototeraphy? Sometimes just use shortcut. No need investigate here and there.

I will be very sad if you're my son's paedi.

why phototheraphy for prolonged jaundice?
no point.

better to investigate cause of jaundice. if rule out all the cause then it is just harmless breast milk jaundice.

i'll be sad for you..........for not empowering yourself with knowledge

For parent, breast milk jaundice is still bad news. Anything above 200 of bilirubin still bad for health even through its caused by breast milk.

Nope.

Phototherapy is contraindicated for prolonged jaundice.
Bilirubin at 200 for day 14 is not even high. Don't require phototherapy.
And bilirubin at 200 at day 14 cause no harm
Nothing bad for health

Please feedback what is the latest situation with ur baby's jaundice condition.

Any1 know where to rent legal phototherapy machine to use at home/confinement center in penang and what is the cost tq

This post has been edited by bamkai: Sep 23 2018, 10:41 AM

go to clinics, and private hospitals.