Management and Caring Strategies for Neonatal Jaundice: A Midwifery Research

The report analyzes the case scenario related to neonatal jaundice in infants and how nursing management strategies can further improvise. The study also discusses future plans, ethical issues, and new parameters for analyzing new nursing and midwifery practices.

MIDWIFERY RESEARCH
TOPIC IS TO CHOSE A
CONDITION FOR A
COMPROMISED NEONATE
AND THE TOPIC I CHOSE
WAS NEONATAL
JAUNDICE

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................3
Case scenario...............................................................................................................................4
Management and caring strategies...............................................................................................5
Literature review..........................................................................................................................6
Critique of Research paper..........................................................................................................8
Ethical issues involved and future recommendations................................................................11
CONCLUSION..............................................................................................................................11
REFRENCES.................................................................................................................................12

INTRODUCTION
Neonatal Jaundice can be understood as yellowish discoloration of the white part in child
eyes and skin where due to bilirubin levels there is extensive sleepiness found among child. It is
important for appropriate treatment to be given in infant, where jaundice attribution further needs
to be checked by doctor. The report will analyze in depth case scenario, related to neonatal
jaundice in infants and how nursing management strategies can further improvise. The study will
also discuss future plans, ethical issues and new parameters for analyzing new nursing and
midwifery practices (Okumura and et.al, 2021).
Complications in neonatal jaundice case include seizures, cerebral palsy where child
condition is worse, if immediate nursing care and supervision from experienced doctor is not
obtained. While working as midwife nurse, I had the opportunity to care for baby as infant was
facing Neonatal jaundice and was unable to feel confident which further hampered productive
functional efficiency. The unconjugated bilirubin level when gets too high, exceeding the
albumin binding capacity, it has become neurotoxic presenting larger scale efficiency in nursing
care. Jaundice may be sign of pathology and demands evaluation rational management by
experienced nurses and doctors, which is likely to reflect pathology and early steps in
treatment. It is important to appreciate that infant symptoms may be attributed to jaundice and
improper feeding , which may decline efficiency in treatment if proper check is not taken up.
Nursing and midwifery practices are highly crucial for child and infants to be provided and taken
up, which further strengthens treatment prerequisites to be done in proper format.
Case study analysis will enable us to gain proper specific information, analysis towards
extended specific details regarding proper care which needs to be done towards child It can be
also understood that post natal care by mifewifery, nurses also holds high specific role to identify
jaundice in the first step. Also specific care by midewifery nursing strategies enhances stable
care among child, where nutrition identification and specific care further adds to longer scale
treatment. The infant case scenario analysis, will strengthen up analysis done based on nursing

parameters and generate medical care to be done properly which adds specific larger scale
technical strengthened goal variedly (Nicolas and et.al, 2021).
Case scenario
While working as nurse in postnatal ward, I found a critical case which was given to my
by supervisor doctors for analyzing where infant was ill and weak, suffering from neonatal
jaundice. The paleness, excess sleeping and rise in temperature within body were some of the
most common symptoms found in infants suffering from jaundice. Case attending training given
to nurses have enabled me to gain expertise, where I found that infant was also suffering from
loss of weight in body duet to fever. The paleness has made child highly weak, in active and was
also excessively crying which further has been found to make as one of the most specific aspect
which needs to be attended immediately (Wang, Fan and Lin, 2021).
 The infant was highly week and was facing health issues as infant jaundice has occurred
and impacted baby blood containment, and bringing yellow pigment of red blood cells. I
while working as nurse faced issue where infant jaundice is common condition,
particularly among babies from 38 weeks’ gestation and some of the breast fed babies
where baby liver is also impacted. The infant liver is not matured properly, where
bloodstream and some underlying diseases are significantly common within nursing
practices. While working as nurse in ward, I immediately took attention towards the
case study, where presence and identification of certain risk factors related to Neonatal
jaundice enabled me to identify severity of the case study. Symptoms I noticed in child
were yellowing of skin and whites in eyes where main sign of infant jaundice were sever,
also it has been found that infant appeared to be suffering from jaundice on second and
fourth day after birth. I while attending to baby case, checked on infant jaundice
immediately, press gently on baby forehead or nose for analyzing case study aspects and
future specific aspects to be taken as nurse (Kuniyoshi and et.al, 2021).
The baby seems listless or sick, difficult be awaken and also lifeless, where infant
liver functioning is improper and also it is unable to gain weight due to feeding poorly.
While practicing nurse, I also identified that baby was making high pitched cries, slow
development as no medicine or food was able to be taken up due to less reaction

potentiality. I got the opportunity to take care of baby with high precautions, as baby has
been facing high health issue and unhealthy due to neonatal jaundice where nursing
preventives needed to be taken up immediately. While checking the baby, I noticed that
weight of infant has dropped excessively and paleness has lowered efficiency aspects
were high pitched crying, backward aching or neck and body along with fever. My
consultation with parents of baby also made it clear that immediate attention and medical,
nursing care needs to be given with consultation with doctor.
I while attending my nursing responsibilities within postnatal ward, I found baby
suffering from neonatal jaundice where immediate management and caring strategies were
employed. Best preventive of infant jaundice is adequate feeding, where breast fed infants should
have eight to 12 mother milk feedings in a day for immediate precaution in days when infected.
Formula fed infants usually should be given 1 to 2 ounces of feeding, as supervised and
recommended by doctor which will further improvise further situation of infant (Savedra and
et.al, 2021).
Management and caring strategies
 Treatment will consist of nursing strategies, where ensuring adequate hydration practices
will encourage baby to recover slowly and also specific temperature care is also checked.
The nursing care strategies such as phototherapy, intravenous immune globulin and
exchange transfusion will be done by specialized doctor. Infant with neonatal jaundice
will be given medications that impact bilirubin metabolism strategies, for improvising
and engaging effective nursing treatment of child under supervision. The infant jaundice
was immediately taken care by specialized nurses and experienced specialized doctor,
where clinically assessing the initial level of jaundice and drawing blood for bilirubin
determinations are done (Demis and et.al, 2021).
 As nurse, I also kept check on encouraging frequent feedings of baby and check on baby
body temperature due to fever which kept proper assessment to be done properly while
attending towards baby’s natal care. While assessing condition and cases study, I also
checked various reasons that led to neonatal jaundice which were baby wasn’t taken
specific care immediately after birth and there were long breaks in feeding. It has been
analyzed that negligence in child nursing and the care negligence by midwifery care often

leads to child be infected from jaundice. Proper nursing care needs to be further also
taken, for ensuring proper natural treatment and medication is given under supervision by
doctor for improvising healthcare of infant.
 The mother of neonate was also prescribed specific meals related with fruits and
vegetables containing strong level of liver friendly nutrients, which will further be
beneficial for child. It has been analyzed that motherly care, nutritious diet and meals are
highly crucial to be recommended, which will make feeding of milk to be nutritiously
done for the infant. It is important for nurses to maintain normal hydration and eternal
nutrition intact within jaundiced newborn infant, where encouragement of breastfeeding
and provision to maintain additional fluid is done. Administration of excessive quantities
of fluid was done to infant suffering from neunotal jaundice, where most feeds are done
precisely to develop hydration in child (Thomas and et.al, 2021).
This can be also analyzed that neonatal jaundice care also specifically formulate
focus towards attending infant proper medicated care, and also supervision by doctor for
childcare specific aspects. While attending to the infant,management and caring strategies
were done keeping in mind high specific need of sanitation and hygienic surroundings
which will further make sure that diagnosis is done proper. Nurses and midwifes play
strong role for attending towards child care, in case of neunotal jaundice where
medication and care strategies are formulated as per specific identification of babies
needs.
Literature review
As per the views of Ding and et.al (2021), neonatal jaundice has been found to be highly
common among increasing cases within infants, where after some immediate days of birth the
increase in child body temperature often leads to decreased efficiency. The author also specifies
in research papers that decline and negligence in child care practices, by midwife or nurse also
often leads to increase in jaundice infection. There should be proper care taken up by nurses,
and identification of mothers medical history as mother feeding has to be nutrition full for
reducing jaundice in child. Research has enabled us to learn that nursing strategies and care
management practices plays strong role for extending functional rise diversely, treating infant
with proper hygienic care practices. Condition of baby as identified in above case study shows

that the case was critical, and also proper diagnosis needs has been taken immediately by nurse
and doctor handling case. Infant neonatal jaundice, have made baby lost body weight and pale,
where feeding of nutritious milk has to be given which further enhances treatment to be done in
proper format.
As noted by the views of Inamori and et.al, (2021) case study analysis enables to analyze
that infant diagnosis and treatment of jaundice by doctor, nurses was done accurately as crucial
for situational emergence. Proper hygiene and sanitation facilities were there in postnatal care
ward, which further made sure that medical care is properly maintained within child care for
making sure that baby feeding is done properly. Symptoms such as paleness in child, is checked
by noticing color bright and preferably quick natural light for effective assessment. Research
papers by author also addresses focus on additional signs and symptoms of increasing jaundice
are lethargic baby, poor feeding habits which further declines baby activeness variedly. Also
keeping check on mother medical history, pre and post natal care practices by nursing and
medical facilities holds high essential role in infant diagnosis. However, there are various other
care needs that can be further prescribed to child where nurses specific care plan will also
improvise new steps for attending case with utmost priorities done.
However, with increasing advancement in medical and nursing practices further medical
care needs enables child to be further improvised in treatment quickly. Mother feeding habits
and specific prescription of diet, further enables child immunity to grow and liver to take up
nutrition absorbed (Dantas and et.al, 2021). With research on above study, case scenario enables
us to identify that child specific care in treatment has to be further significantly monitored for
future improvements and strengthened abilities. Symptoms should be monitored immediately,
checked by nurses and doctors for further improvised competencies which further also enhanced
abilities in child where further nursing efficiency adds value variedly. Author also further
identified in research papers, that neonatal jaundice has been further found to be highly risk if
immediate attention not given by nurses and doctors. This further also heads on strong focus for
larger scale improvement aspects, enhanced working parameters where baby postnatal care
should be medicated by doctor and trained nurses. Also, specific identification of symptoms and
immediate care strategies strengthens functional rise in improved health habits of child suffering
from jaundice.

There are varied other review techniques and monitoring aspects, which can be
taken up by nursing department and midwifery practices where keeping check on infant body
should be done at regular intervals. Within case study, it has been also found that some
negligence on terms of time periods for treating neonatal jaundice has been there which has not
present which further also reduced significant care practices to be done in proper format. There
should be also usage of specific treatments taken up, where medical nursing strategies
improvisation further enhances abilities to be evolved significantly. Nurse and midwifery
practices also has scope to further guide parents regarding condition of infant , which will
further also improvise new vision to be formed for proper care to be done. Furthermore ethical
notes and working efficiency by keeping in mind proper treatments, should be taken care for
further health improvement in baby. Detailed accurate specific medication, nutrition fulfillment
also adds to connective growth imperatively based on larger scale paradigms dynamically which
further signifies child care (Bratton and et.al, 2021).
Critique of Research paper
The topic is related to the Neonatal Jaundice situation which is mainly identified in
children’s or babies. Main purpose of this research paper is to determine actual practices that
support for screening the Neonatal Jaundice disease. Through the level of knowledge and
different practices pattern that are presented by medical practitioners. To analyse the different
practices which exists among different medical practitioners, if following a proper guideline for
screening and management of Neonatal Jaundice.
Usually, it has been selected by targeted group from young children’s who aged in
between 5-10 years and also consider the role of 390 registered Midwives. Critically, it has been
applied the proper national guidelines for purpose of screening, follow-up and management of
new born. On the basis of investigation, it continues to be identified the most common cause of
neonatal readmission to the different hospitals in North America. If it has not rapidly giving a
proper treatment effectively, otherwise it may server as hyperbilirubinemia. This kind of
condition is majorly devastating as long term consequences. Although, it was consider as largely
preventable disease, in this case it may create an alert message, with 200+ infants are
representing with sever Neonatal Jaundice during 2-3 years period (Management of Neonatal
Jaundice varies by practitioner type, 2013). According to the relevant data or information, it was

established a program or event which may support to reduce level of mortality rate. Afterwards,
it continued to happen the different attempts in identifying at certain risk factors among new-
borns before discharge from hospitals, other agencies.
In 2007, Paediatric society will promote the good practices in context of complication
related Neonatal Jaundice. Sometimes, it also supporting to the screening and management of
complex disease consequences. Moreover, it also including importance or significance of
screening all kind of newborns, where it cannot applicable at the time of risk factors. But at some
point of view, it may be identified the infants with proper evidence of Neonatal Jaundice disease.
Based on the evidence or finding, it has been examined the assess knowledge of
translation and extent to which represents a proper guideline. Sometimes, it also known as
practiced as management through national guideline.

Critically evaluate the research paper and gain basic idea about the Neonatal Jaundice,
conducting the cross sectional survey. Usually, it has been selected the medical practitioners
which involved in care of new born or children because of Neonatal Jaundice. This is the most
commonly occurred health compilation. By considering the medical directory, which captures
almost 80% of all its medical practitioner. These are usually maintain a proper list of information
where physicians understand the reason behind complex health problem. By using
questionnaires, it has been estimated the proportion of family physician and other medical staff
members. On the basis of survey, it has found that 80% respondents a show positive response
and believe that Neonatal Jaundice common issues. But Midwives registered associated with
survey and obtain sample size 100 responses (Management of Neonatal Jaundice varies by
practitioner type, 2013). Moreover, it also conducting the process of randomization program,
give a major contribution to the result findings. Whenever, it was completed the respondents
views which are mainly stored in the encoded format. Because of low response rate and find the
similarities in their practices, scopes and other medicine practitioners, which are grouped
together or labeled. On the basis of evaluation, it is majorly identified the variability in the
guideline and also consistent with previous studies. The involvement of individual family
physician might not see new borns and children in frequently. Therefore, it has been putting
some efforts on ensuring the significant role of Midwives registered in the hospitals before
discharging.
As per increasingly the involvement of different respondents in context of Neonatal
Jaundice and understand the actual case scenario of a new born. Through research paper, it is
critically supports the concept that once Neonatal Jaundice and its risk factors are recognized.
Afterwards, medical practitioners are also respond as frequently, unfortunately it may occur the
situation of health problem due to the Neonatal Jaundice. This type of research study was
representing as unique thing because of involvement in family physicians & midwives included.
On the basis of analysis, the strength of this study was its technique such as unbiased sampling,
random technique. Moreover, it also obtained the ability of information or data on the basis of
respondents.

Ethical issues involved and future recommendations
Nursing for neonatal jaundice among infant, also holds high engagement based on
keeping check on varied ethical issues and to check on further medical properties which
enhances scope for wider improvement. Ethical issues such as keeping check on body
temperature, sanitation will further improvise child to be treated with high safety and also further
engage on proper care to be delivered.
 This also heads on specific focus for prolonged rise towards integrated channelizing
services, in nursing by forming care plan and also integrating specific needs of child care
further will enhance outlook. Within infant care plan, nurses and midwifes should be
specific for extending best services as per situational factors for improvising new plans
effectively for varied extended channels. Ethical issues such as handling case, by taking
up communication meetings with child parents will further enhance outlook of nursing
care to be delivered within infant (Yan, Zhou and Kang, 2021). It can be also analyzed
that within future recommendations, case study also presented strong focus for
enlightening focus towards extended specific nutrition care to be given to child as per
specific treatment parameters.
 Future recommendations and aspects, such as enabling best hygienic food facilities and
medications to be delivered among hospital will enhance overall outlook variedly. Infant
suffering from neonatal jaundice, further also needs to be monitored and kept check for
proper treatment prescription which will improvise care plan evolving synergy to be done
properly.
CONCLUSION
The report has concluded neonatal jaundice is often found in children who are recently
born, and due to weak immune system and weak liver the rise in internal temperature and fever
often leads to jaundice. Midwifes and nurses should be effective in handling child case
effectively, by analyzing best medical strategies discussed with supervised doctors for further
frequent medications.

REFRENCES
Books and Journals
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Demis, A., and et.al, 2021. Knowledge on neonatal jaundice and its associated factors among
mothers in northern Ethiopia: a facility-based cross-sectional study. BMJ
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Ding, J., and et.al,., 2021. Gut microbial alterations in neonatal jaundice pre-and post-
treatment. Bioscience reports, 41(4), p.BSR20210362.
Inamori, G., and et.al, 2021. Neonatal wearable device for colorimetry-based real-time detection
of jaundice with simultaneous sensing of vitals. Science Advances, 7(10),
p.eabe3793.

Kuniyoshi, Y., and et.al, 2021. Neonatal jaundice, phototherapy and childhood allergic diseases:
An updated systematic review and meta‐analysis. Pediatric Allergy and
Immunology, 32(4), pp.690-701.
Nicolas, N.J., and et.al, J., 2021. Inverse Opal Films for Medical Sensing: Application in
Diagnosis of Neonatal Jaundice. Advanced Healthcare Materials, 10(4),
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Okumura, A., and et.al, 2021. Neonatal jaundice in preterm infants with bilirubin
encephalopathy. Neonatology, pp.1-9.
Savedra, R.M.L., and et.al,., 2021. White LED phototherapy as an improved treatment for
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Thomas, M., and et.al,., 2021. Mechanism of bilirubin elimination in urine: insights and
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(CCLM), 59(6), pp.1025-1033
Wang, W., Fan, Y. and Lin, Q., 2021. Metformin combined with insulin aspart for ameliorating
blood glucose levels and maternal and neonatal outcomes in women with
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Online-
Management of Neonatal Jaundice varies by practitioner type, 2013
[online] Available through:<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743715/>