‘Early breastfeeding can prevent Jaundice’

How do you view jaundice, and why is it suddenly a concern? Neonatal jaundice (jaundice in newborn) is different from jaundice in adults. It is so severe it can damage a baby’s brain. Therefore it is better to prevent than treat it. We are worried because the rate of jaundice in the country now is […]

How do you view jaundice, and why is it suddenly a concern?
Neonatal jaundice (jaundice in newborn) is different from jaundice in adults. It is so severe it can damage a baby’s brain. Therefore it is better to prevent than treat it. We are worried because the rate of jaundice in the country now is getting too frequent. It shouldn’t be so. We worry  because people at community levels are not aware of what to do to prevent it being severe.

What causes jaundice?
Most babies when they are born appear jaundiced, because of the yellow colouration on the body, most especially the eyes and tip of the nose. [Heme] Red blood cells are high in the baby born and begin to break down, producing bilirubin – that’s what causes the yellowness of the skin. That on its own should not cause any problem. Once the baby matures a bit more, he can get rid of that bilirubin, and the jaundice should clear.
In some cases, it can be so severe that it damages the baby’s brain. The other thing that makes the heme breakdown very complex is: some of our mothers use camphor to preserve baby’s nappies. That can cause jaundice, as with infection in babies (some mothers use leaves to clean the umbilical cord. That can cause infection and jaundice). Breast milk on its own can cause free bowel movement in the baby, and by doing so the early stool contains a lot of bilirubin, which is washed out. Early breastfeeding helps prevent jaundice. It is a simple thing, not too complex for our communities, but most importantly, mothers should realize this, and look out for jaundice and take action once it occurs.
The most important action should be to go to the nearest health centre. Do not put the baby in the early-morning sunshine, because you are wasting time. Giving ampicillin drops might not help, because the cause may not be an infection. The treatment is definite, so go to hospital. Also initiate breastfeeding as early as possible; that will help the baby clear its bowels and prevent jaundice.
For hospital based treatment, at times babies could be put under blue light, and at times if it is severe, [a blood transfusion is required]. But that’s hospital matter. What’s most important is for the mother to know: once there’s a change in colour, go to hospital. Again don’t put babies in dark rooms, as done in some cultures; when that happens the mother can’t see the baby’s colour.

What is Neonatal Society doing to slow the rate of jaundice?
We are putting together a document called Information to Mothers at Community Level. What will make that possible is anywhere you are in this country, you get a pamphlet or leaflet telling you what jaundice is, how it is caused, prevented, what to do when you see it, in very simple language. That document will be translated into all the major Nigerian languages and pidgin.
We are going to train health workers at community level so that they also help see these mothers and their babies when the baby is born. Some babies are born at home, not in hospital. These community health extension workers visit these babies at home particularly on the first day to ensure their colours are normal, the umbilicus is clean, the baby is breastfeeding properly and so on.

We know the benefits to breastfeeding, yet that intervention is something some women still don’t want to do. What’s behind that?
Breast milk has definite advantages but most importantly it protects babies from infections. Secondly, there is that bonding between mother and baby. Again mothers that breastfeed don’t have certain cancers – of the breast, cervix and so on. Babies breastfed are more intelligent than those not breastfeed.
Nigerian mothers still breastfeed, but what we preach is that breastfeeding should be exclusive in the first six months – one hour after birth until age of six months, thereafter the mother can add akamu and cereals. But the breastmilk continues. The first two years are very important. If the baby is not properly fed in the first two years, problem arises.

So why aren’t they breastfeeding?
I don’t know. As at today only 17% of mothers in Nigeria are breastfeeding exclusively, and that’s not good for the country. Many mothers now work or look after the household. But government can make policies to improve or increase maternity leave. Some working areas like banks or offices should have a crèche where mothers can take their babies during work, then take a break and go breastfeed.

With breastfeeding rates so low, what is the chance of survival of neonatals in Nigeria?
There lies a problem. Forty percent of every 1,000 babies born die in the first four weeks of life, and we know that breastfeeding can prevent that. What about infants up to their first one year of life: 89 out of 1,000 of them die, which is very high. Again in the first five years, children also die. A lot of these deaths can be prevented through breastfeeding. What do they die from: infection, birth asphyxia, prematurity. The major thing is infection and that can be prevented by exclusive breastfeeding.

What other challenges face neonatal survival?
Jaundice is just one. There are infections like tetanus, which kills a lot of babies, then pneumonia, diarrhoea. The biggest killer is infections, and that’s why we emphasize breastfeeding to prevent babies getting infections.