Monday, August 25, 2008

Jaundice!!

25.08.2008 - 2354hrs

Jaundice or demam kuning in malay!! I heard a lot about it but never cared to know more about it till it infects your own child!! All I know is that when a new born is diagnosed with jaundice, its skin is yellowish for a while and after treatment it will go away...

So Maya was diagnosed today with Jaundice....and poor mum and baby had to be detained in the hospital for further treatment.

So what is Jaundice?
As reporter below in http://kidshealth.org/parent/pregnancy_newborn/common/jaundice.html

A common condition in newborns, jaundice refers to the yellow color of the skin and whites of the eyes caused by excess bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells.

Normally, bilirubin passes through the liver and is excreted as bile through the intestines. Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body. Reasons for this include:
Newborns make more bilirubin than adults do since they have more turnover of red blood cells.

A newborn baby's still-developing liver may not yet be able to remove adequate bilirubin from the blood. Too large an amount of bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool.

High levels of bilirubin — usually above 25 mg — can cause deafness, cerebral palsy, or other forms of brain damage in some babies. In less common cases, jaundice may indicate the presence of another condition, such as an infection or a thyroid problem. The American Academy of Pediatrics (AAP) recommends that all infants should be examined for jaundice within a few days of birth.

Types of Jaundice
The most common types of jaundice are:

Physiological (normal) jaundice: occurring in most newborns, this mild jaundice is due to the immaturity of the baby's liver, which leads to a slow processing of bilirubin. It generally appears at 2 to 4 days of age and disappears by 1 to 2 weeks of age.

Jaundice of prematurity: occurs frequently in premature babies since they are even less ready to excrete bilirubin effectively. Jaundice in premature babies needs to be treated at a lower bilirubin level than in full term babies in order to avoid complications.

Breastfeeding jaundice: jaundice can occur when a breastfeeding baby is not getting enough breast milk because of difficulty with breastfeeding or because the mother's milk isn’t in yet. This is not caused by a problem with the breast milk itself, but by the baby not getting enough to drink.

Breast milk jaundice: in 1% to 2% of breastfed babies, jaundice may be caused by substances produced in their mother's breast milk that can cause the bilirubin level to rise. These can prevent the excretion of bilirubin through the intestines. It starts after the first 3 to 5 days and slowly improves over 3 to 12 weeks.

Blood group incompatibility (Rh or ABO problems): if a baby has a different blood type than the mother, the mother might produce antibodies that destroy the infant's red blood cells. This creates a sudden buildup of bilirubin in the baby's blood. Incompatibility jaundice can begin as early as the first day of life. Rh problems once caused the most severe form of jaundice, but now can be prevented with an injection of Rh immune globulin to the mother within 72 hours after delivery, which prevents her from forming antibodies that might endanger any subsequent babies.


Symptoms and Diagnosis

Jaundice usually appears around the second or third day of life. It begins at the head and progresses downward. A jaundiced baby's skin will usually appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant's eyes to appear yellow.
Since many babies are now released from the hospital at 1 or 2 days of life, it is best for the baby to be seen by a doctor within 1 to 2 days of leaving the hospital to check for jaundice. Parents should also keep an eye on their infants to detect jaundice.

If you notice your baby’s skin or eyes looking yellow you should contact your child's doctor to see if significant jaundice is present.

At the doctor's office, a small sample of your infant's blood can be tested to measure the bilirubin level. Some offices use a light meter to get an approximate measurement, and then if it is high, check a blood sample. The seriousness of the jaundice will vary based on how many hours old your child is and the presence of other medical conditions.

When to Call the Doctor
Your doctor should be called immediately if:
jaundice is noted during the first 24 hours of life
the jaundice is spreading or getting more intense
your baby develops a fever over 100° Fahrenheit (37.8° Celsius) rectally
if your child starts to look or act sick

Also call the doctor right away if the color deepens, your baby is not feeding well, or if you feel your baby is sleepier than usual. It is difficult to tell how significant jaundice is just by looking at a baby, so any baby who has yellow eyes or skin should be checked by the doctor.


Treatments
In mild or moderate levels of jaundice, by 1 to 2 weeks of age the baby will take care of the excess bilirubin on its own. For high levels of jaundice, phototherapy — treatment with a special light that helps rid the body of the bilirubin by altering it or making it easier for your baby's liver to get rid of it — may be used.
More frequent feedings of breast milk or supplementing with formula to help infants pass the bilirubin in their stools may also be recommended. In rare cases, a blood exchange may be required to give a baby fresh blood and remove the bilirubin.

If your baby develops jaundice that seems to be from breast milk, your doctor may ask you to temporarily stop breastfeeding. During this time, you can pump your breasts so you can keep producing breast milk and you can start nursing again once the condition has cleared.

If the amount of bilirubin is high, your baby may be readmitted to the hospital for treatment. Once the bilirubin level drops and the treatment is stopped, it is unlikely that treatment for jaundice will need to be restarted.

Reviewed by: Larissa Hirsch, MDDate reviewed: June 2008

Fatherhood 2.0




25.08.2008 - 0100hrs


5 days since the birth of my second child, Maya....somehow, it still has not sunk in the fact that I'm now a father of 2 kids. Maybe because Maya is still sort of sleeping most of the time and Leilani's the one being so animated, in fact kind of extra animated nowadays....



Since the birth of Maya, I have put myself on a quest...to try and make the arrival of the little one as comfortable as possible for Leilani. I've read and heard a lot of tales of how the first born gets all jealous and stuff the moment he or she gets a younger sibling. So my quest is that - to try and make her not feel so jealous..




The first day Maya came back with us, it was kinda cute to see Leilani all upset because she can't play with her lil' sister who was always asleep. "I wanna play with baby!!" she kept crying out.



But signs of her jealousy could already been seen just as her mom was about to be discharged from the hospital. She insisted on sharing the wheelchair ride with her mom and Maya....


And lately, since being a big sis, Leilani seemed to be abit more naughtier the usual....it's as if she's trying to pull everyone's attention away from poor lil' Maya towards her....just like a lil' diva....



Well...I'm trying my level best to pay more atention to Leilani...like greeting her first, as I usually do, when I come home from work before actually seeing to the baby...I also try not to stress on the 'big sis', 'lil sis' when I talk to her...just try and act as normal as I can....somehow I always have this urge of buying pressies but I believe it would make things worst...



Hopefully, my dear Leilani will grow out of this whole situation and become a good, doting sister like every parent wishes for....then in the meantime, I could give my equal love an attention to my lil' Maya...
Ya Allah! Please give me thy strength and guidance to be a fair and loving father to both my beautiful princesses....Amin...

Thursday, August 21, 2008

The miracle of birth, for the second time....




20.08.2008

A very unique date indeed. And a very meaningful one for me....For on this date, my second daughter was born. Ladies and Gentlemen of the world, I proudly present to you, the latest addition to my familia, Ms Maya Sharezal.

Initially, her due date was expected to be on the 4th of September this year. However, somehow, fate was written for her to arrive sooner, and on such a unique date!!!

I received a call at work on 19 August, 2008 from Lissa at around 2pm to say that she had a very bad backache, and was on the way with her parents to PUSRAWI Hospital to meet her new favourite gynae, Dr Marsitah, who substituted Lissa's usual gynae, Dr Nora as she was away on holiday. Somehow after thorough check-up, Lissa was found to be already 3cm dialated and had to be admitted for monitoring. When Lissa told me this, I stupidly asked "Are you sure?" and Lissa answered, "no I'm not. So shall I meet you at the hospital?" Without any further delay, I rushed to my boss's office and told her that I had to zoom off.

Lissa was admitted in the Delivery Room of PMC at around 7-ish pm. By 9.30pm, her water broke.....and soon the contractions began, slowly but surely.....by 1230am, it began to be more intensed, by the way Lissa was gritting her teeth, and also by the way my hands were being squeeazed. At first, being so called 'experienced' with the birth of our first born 2 and a half years ago, we thought that the whole thing would be a breeze....but lo and behold!!! This time round it was a drag, and the Lissa was in labor longer then her first child!!! At 0430hrs, Dr Marsitah, dropped by to check on things and suggested for some drip to further enhance the contractions to assist to guide the baby to find it's way downwards.....this meant more pain....poor Lissa....but she was strong!! Am very proud of her....no matter how big a man's ego can be, surely he will crumble like a wimp if he experienced childbirth....I will be the first to admit it!!!

By 0830am on 20.08.08, Lissa was only about 8cm dialated.....we began to worry as it looks like there might be a possibility of a c-section....but alhamdulillah, after a gruesome 1 hour of really crazily painful contractions...(her fingers and knuckles while squeezing my hands were already turning from yellow to white!!!) at around 0930hrs, the doctor came in with her entourage and said - "this is it" And after about 4 really hard pushes, our 9.28kg baby Maya was born on 20.08.2008, at 0944hrs....








Alhamdulillah......