Jaundice. One of the most common minor complications in the newborn is jaundice which affects up to 50 per cent of babies and an even greater number of preterm infants.

Physiological jaundice occurs on the third or fourth day and is caused by the babys liver being unable to cope efficiently with the breakdown of the extra load of red bloodcells in the babys circulation before birth. The child is not ill, gains mass and has normal stools. The condition usually rectifies itself within a week. Tests will be done and if the level of unconjugated bilirubin (unconverted waste) is above a certain level (the danger level is lower in preterm infants), the baby will be put under special lights for about 48 hours. Exposure to these lights converts the unconjugated bilirubin into a harmless form that is then excreted

through the urine and stools, which is why the urine of a baby who is under the lights is brownish, and the stools appear green and loose. The babys eyes will be protected from the harsh light and she will be brought to the mother for feeds. There are no known after-effects from this kind of jaundice and its treatment.

Jaundice on the first or second day of life may be a sign of a serious condition. (See p. 263.)

Third-day blues. By the third day you, too, may be feeling somewhat off-colour. If you have had a Caesarean, you will probably be in pain from wind and the wound, and no matter how your baby was delivered your breasts will be starting to fill with milk (unless you have had an injection to stop it). See p. 75 for advice on engorgement and how to breast feed in the first days.

Besides discomfort from episiotomy stitches, you may have difficulty with bowel movements and suffer other indignities that are part and parcel of motherhood. Not surprisingly, you begin to feel the romance has gone out of having a baby. Besides this, your hormonal secretions – those arbiters of equilibrium – are sending out messages in scrambled code. No wonder you are alternately laughing and crying.


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