November 20, 2017

Beware of Jaundice and other baby killers – Emeka Nwolisa

Beware of Jaundice and other baby killers – Emeka Nwolisa

Nigeria is a country awash with myths. The ones surrounding death are legion, especially if death occurs in childhood and is repetitive.  We name names, some witty, some explosively expressive, some pleading and some defiant.  The ones directed at death often cut across all spectrums and not only are they full sentences on their own; they are explicit and  often self explanatory. Wy is this so? Maybe because death evokes a wide range of emotions bordering on pain, anguish and occasionally, guilt.

These unique names often transcend generations bearing their tales and repeating their story.   Let’s examine the common ones across the Igbo ethnic group. The  accusatory ones include Onwudinjo (death is evil), Onwuamaegbu (death is an indiscriminate killer), the pleas include Onwubiko( death please spare), those expressing  despair include Onwuamaenyi (death knows no friends), Onwuameze (death knows no king), Onyekonwu (who is greater than death?).

In defiance children have been named Kashimawo (lets watch and see), Onyano (will this stay). These names are spurned by lack of understanding of the probably causes of these repetitive childhood deaths and  typically , what we can’t explain, we  often ascribe to the supernatural.

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But then are  these childhood  deaths  really of supernatural origin?

Several medically explainable conditions can cause repetitive childhood deaths in a family. They could range from haemoglobinopathies like sickle cell anaemia to several congenital malformations or abnormalities? They could also arise from complications of severe neonatal jaundice which could result from such causes as Rhesus incompatibility amongst others .

Jaundice is one of the most common conditions requiring immediate medical attention in newborns. The yellow coloration of the skin and sclera(eyes) in newborns with jaundice is the result of accumulation of  bilirubin.  Bilirubin is  a waste product from the breakdown of  red blood cells.  In most infants, this accumulation of bilirubin  reflects a normal transitional phenomenon. However, in some others, serum bilirubin levels may rise excessively. This is of medical concern  because unconjugated bilirubin is toxic to the brain and can cause death in newborns and lifelong neurologic complications and effects  in  those who  survive.

Risk factors for jaundice in newborns  include Rhesus incompatibility where the mother has a Rhesus negative blood group. To a lesser extent ABO incompatibility can also increase the risk. Babies born pre-term and those with low birth weight are also at risk. The risk is also high in babies born by mothers who are diabetic.

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If not quickly detected and managed  Kernicterus can develop. Kernicterus is the syndrome that occurs if excessively high bilirubin level  cause permanent damage to the brain.  This damage can manifest as :

  • cerebral palsy – a condition that affects a child’s movement and co-ordination
  • hearing loss – which can range from mild to severe
  • learning difficulties
  • involuntary twitching of different parts of their body
  • problems maintaining normal eye movements – people affected by kernicterus have a tendency to gaze upwards or from side to side rather than straight ahead
  • poor development of the teeth

Steps towards preventing neonatal jaundice include appropriate and effective antenatal care where risk factors could be identified and addressed.   Every newborn should also be examined and effectively evaluated by a doctor  and  where need be a test to ascertain bilirubin level should be requested before discharge.

So when next you want to name a child……think deeply!

 

Radi8
InnJoo Reborn

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