The Management of Neonatal Jaundice in Nigeria

Jaundice is yellowish discolouration of the skin, sclera and mucous membranes.1 Neonatal jaundice (NNJ) is so common that it can be regarded as a normal physiologic adaptation of the newborn infant to extrauterine life. However, it may also be a symptom or sign of an underlying disease. Neonatal jaundice is due to increased serum levels of bilirubin, a pigment derived mainly from the breakdown of haemoglobin. It becomes clinically visible when serum bilirubin level exceeds 5 mg/dL. Worldwide NNJ is an obsession of neonatologists because of the association between raised unconjugated bilirubin levels and permanent neurological damage.2-6 Newborns produce bilirubin at a rate of 6-8 mg/kg/ day which is more than twice the production rate in adults.7,8 This is due to relatively large red cell mass, shorter red cell life span causing increased red cell turn-over in neonates.9 Bilirubin production in neonates however declines to adult level within 10 to 14 days after delivery.7 The prevalence of neonatal jaundice in clinical practice range between 23–60%.1 Jaundice is noticed during the first week of life in about 60% of term infants and 80% of preterm infants with only a few signifying underlying disease. IFEMED Journal Vol. 14 (1) 2008: pp. 18-2