Ɓooygol ndiyam e nder reedu jibinaaɗo keso, ɓuuɓri tiiɗndi (Bilirubin), e banngeeji boɗeeji e yontere adannde¶

Balɗe 7 gadane nguurndam aadee, haa teeŋti noon e Balɗe 2 haa 5, ɗoon e ɗoon caggal nde cukalel ngel yalti galle mum e nder suudu safrirdu jibinannde, ina hollita mbayliigu fisik toowngu. E nder ndeeɗoo winndannde, ƴiiƴam yumma ina wayloo haa jooni e nder ƴiiƴam ɓiɗɗo gorko (laktogenesis II, ko ɓuri heewde e mum ko hakkunde waktuuji 72 e 96 caggal jibineede), heeñere jibinaaɗo keso oo ina hatojini e jokkondirde e ɓuuɓri mawndi e ƴiiƴam mboɗejam gonɗam e nder reedu (lactogenesis II). njuɓɓudi e ballal ndiyam caggal reedu. Sabu hiperbilirubinemiya tiiɗɗo e ŋakkere ndiyam hipernatremik ina tiiɗtina koye mum en e nder cirƴam bonɗam, cukalel ngel ŋakkere ndiyam, ngel ŋakkiraaka nguura, ina ɗaani no feewi, ɗum noon ina haɗa yaltude ƴiiƴam, ina addana bilirubin ruttaade e ɓalndu, artira e nder ƴiiƴam, ina waawi ustude maale ñawu nguu (kernikterus) walla ɓuuɓri ƴiiƴam e nder waktuuji 12 haa 24.

Jibnaaɓe kesi ina keewi majjere lethargy (ɓiɗɗo tooke, ɓuuɓɗo, walla septik mo waawataa wuurde ngam nyaamde) ngam "ɗaanirde moƴƴere, deeƴnde." E rewindaade limtooji safaara laaɓtuɗi, paayodinɗi, limre ñalnde kala e paɗe ɓuuɓɗe e dirtuɗe, yaajde Kramer e hoore haa koyɗe e ɓuuɓri ɓalndu, mbaydi ɓuuɓri e ɓuuɓri, e nguleeki reedu, jibnaaɓe ina mbaawi anndude nguurndam-ɓalndu ko adii nde ɓuuɓri jibinannde ina waawi bonnude.

Waɗde ɗum jooni¶

1. Noddu limoore emergency nokku maa ɗoon e ɗoon so tawii ɓiɗɗo maa keso oo ina hollita kala maande mboros gonɗo e nder reedu, fooftere, walla bilirubin: Noddu 911 to leyɗeele dentuɗe Amerik e Kanadaa, 112 e nder Dental Orop, 999 to Dental Dowlaaji Amerik, walla 000 to Ostarali (ƴeew limooje caɗtuɗe) so tawii ɓiɗɗo maa jibinaaɗo oo waawaa umminde ngam ñamminde, ina nana limde no ragdoll nii walla arches wutte mum e ɓalndu mum ina tiiɗi caggal (opisthotonos), ina jogii wullaare toownde, nde alaa ɗo haaɗi, ina jogii jawdi ɓuuɓndi e nder waktuuji 24 gadani ɗii koyɗe, walla ko foofde ko ɓuri 60 fooftere e nder hojomaaji tawa ina waɗi ɓuuɓri ɓalndu walla leppi daneeji.
2. Yah to Departemaa Emergency Hospitaal ɗoon e ɗoon so tawii ɓiɗɗo maa ina ɓuuɓtoo ndiyam ɓuuɓɗam walla ɓuuɓɗam ɓuuɓɗam (bilious emesis): Hoto ɗaɓɓu noddaango doktoor sukaaɓe so tawii ɓiɗɗo jibinaaɗo oo ina ɓuuɓtoo walla ina ɓuuɓtoo ɓuuɓri ɓaleeri walla ndiyam ɓuuɓɗam huɗo/neon-green (marlike green marker). Nandugol e ɓuuɓri ɓaleeri ndi alaa ko bonnata e kosam ɗam walla ɓuuɓri ƴiiƴam, ɓuuɓri ɓaleeri biliyoŋ e nder cukalel keso ina hollita ɓuuɓri ɓalndu (malrotation avec midgut volvulus), ɗo ɓalndu ɓuuɓndu nduu waawi maayde e nder waktuuji seeɗa tawa opereeji sukaaɓe mbaɗaani.
3. Ƴettu nguleeki ɓalndu dijital e kala cukalel ngel ɗaaniiɗo, ɓuuɓɗo, ɓuuɓɗo, walla ɓuuɓɗo: E kala cukalel ngel duuɓi mum njahrata e balɗe 28 (e haa balɗe 60), nguleeki ɓalndu ko 38,0 degere Celsius (100,4 degere toowɗo alowre Fahrenheit or) 36,0 degere Celsius (96,8 degere Fahrenheit)** (hipotermi ko no jibinannde keso hollirta sepsis), ina ɗaɓɓi yaɓɓude ko yaawi to Departemaa Emergency Hospitaal. Hoto meeɗ rokkude cukalel ngel asetaminofen (Tylenol/paracetamol) walla ibuprofen hade mum ƴeewndaade cukalel ngel.
4. Toɓɓu no feewi e ɓalndu ɓiɗɗo maa e nder annoore ñalawma ngam ƴeewde no ɓuuɓri ɓaleeri ndi yaajiri les ɓanndu nduu: Ɓoornu ɓiɗɗo maa keso oo sara feɗeendu e nder annoore naange (bulbes intérieures yellow artificiels suuɗata ɓuuɓri). Toɓɓu junngo wooto no feewi fotde leƴƴanɗe 2 e tiinde, e ɓalndu, e reedu, e koyɗe, e sole koyɗe, caggal ɗuum ƴettu junngo maa ngam ƴeewde ɓalndu nduu hade ƴiiƴam pinndi artude. So tawii mbaydi oole feeñii e kala nokku e ñalawma 1 (ko ina tolnoo e waktuuji 24), walla ina yaaji haa les reedu haa les koyɗe, paɗe, walla ŋoral koyɗe, yah ƴeewndo ƴiiƴam bilirubin ko yaawi ɗoon e ɗoon.
5. Ƴeewto limngal paɗe ɓuuɓɗe e dirtuɗe waktuuji 24 e ñalngu nguurndam ɓiɗɗo maa tigi-rigi: Ƴeewto so tawii ɓiɗɗo maa ina yahdi e kuule paɗe ɓuuɓɗe ñalnde kala ɓurɗe famɗude (**1 paɗe ɓuuɓɗe e ñalawma 1, 2 e ñalawma 2, 3 e ñalawma 3, 4 e ñalawma 4 onward, e 6+ diaper5a gila **t diaper5a). So tawii ɓiɗɗo maa keso oo yahrii ko ɓuri waktuuji 8 haa 12 tawa alaa paɗe ɓuuɓɗe caggal ñalawma 3, walla ina jogii kiristaal urate "brick dust" orange-pink chalky e nder paɗe ɗee ñalnde ñalnde 5 walla caggal mum, jokkondir e doktoor sukaaɓe maa hannde, ɓeydu heen ñamri ɗoon e ɗoon no yamiraa nii.
6. Hoto meeɗ rokkude cukalel ngel ndiyam laaɓɗam, ndiyam suukara, walla ñamri ɓuuɓndi, kadi hoto meeɗ waɗde cukalel ngel ɓuuɓri e nder lewru direct window ngam lomtaade fototerapi safaara: Hokkude cukalel ngel ndiyam laaɓɗam ina ɓuuɓna ƴiiƴam sodium, ina addana seppude mboros ndiyam. So tawii cukalel ina ŋakki ndiyam walla ina wondi e ɓuuɓri, ina hatojini e waylude kosam ɗam, ñammin kosam ɗam/kosam ɗam walla kosam ɗam ɓuuɓɗam ɗam jillondirɗam no haanirta nii e nder siriŋ, e cukalel, walla e butelaaji tawa ina ɗaɓɓa safaara.

Yontere adannde jibinaaɗo keso oo, ko ɓuuɓri triage¶

flowchart TD
    Newborn["Cukalel jibinaaɗo (Balɗe 1 haa 28 nguurndam) Ƴeewndo"] --> RedFlags{"1. Kala maandeeji gonɗi e nguurndam ɗoon e ɗoon ?"}
    RedFlags -->|"Waawaa Ummitaade ngam Nyaamde, Ɓooygol/Arko, Tempere Rektal >= 38.0C walla < 36.0C, walla Foofde > 60/min"| ERNow["YAAH TO ƊAƊƊAARE HOSPITAL ƊOO ƊOO (Noddu 911 / 112 / 999 so tawii ko Siyanotik walla Apneik)"]
    RedFlags -->|"Ɓoorno-ɗaa wutte daneejo walla ɓaleejo-huɗo ɓaleejo (Bilious Emesis)"| Volvulus["ƊAƊƊI ƊAƊƊI (Risk Volvulus Midgut): Woppu ñamminde, yah to suudu safrirdu ER Jooni"]
    RedFlags -->|"Alaa Sepsis Akut walla Maale Opereeji"| JaundiceCheck{"2. Ƴeewto ɓalndu e gite e nder lewru: Mbele ɓiɗɗo oo ko oole?"}
    JaundiceCheck -->|"Yellow E nder Waktuuji 24 Gadani Jibinannde WALLA Yellow e dow Palms/Soles WALLA E Ɗaanaade"| BilirubinER["KIRIIS BILIRUBIN JAAWƊO: Yah to opitaal ER Jooni ngam ƴeewndo ƴiiƴam Stat TSB e fototerapi"]
    JaundiceCheck -->|"Yellow Mild e Yeeso/Koppi Tan (Balɗe 3 haa 5) e Nyaamde e Yaakaare"| DiaperCheck{"3. Ƴeewto Limngal Diaper Wet e Dirty ngam ñalngu nguurndam tigi-rigi"}
    JaundiceCheck -->|"Alaa Jawdi"| DiaperCheck
    DiaperCheck -->|"Paɗe ɓuuɓɗe seeɗa ɓuri ñalawma nguurndam, kiristaaluuji brik-dust caggal ñalawma 4, walla ɓuuɓri ɓaleeri haa jooni e ñalawma 5"| Dehydrated["DEHIDRATION / LESS NYAAMDU BANDE BOƊƊO: Ɓeydude kosam/Formula Jooni e ƴeewndo sukaaɓe ñalnde wootere"]
    DiaperCheck -->|"Kawral Denndaangal Paandaale Ɓoornugol Seedy Wet e Yellow; Waɗde Kala 2 haa 3 Hrs"| Normal["Jokkude ñamminde laabi 8 haa 12 e nder waktuuji 24 e jokkude ñalnde 3 haa 5 njillu doktoor sukaaɓe"]

1. Limre ñalnde kala ɓiɗɗo jibinaaɗo, mbayliigu ƴiiƴam, e limto ŋakkere teddeendi (Balɗe 1 haa 7)¶

Sabu a yiyataa no mililiteeruuji kolostrum walla kosam ɓiɗɗo jibinaaɗo ina ɓuuɓna e kala sahaa nde o ɓuuɓnata, ko yaltata e nder paɗe ko kañum tan woni njuuteendi safaara gooto ɓurɗo laaɓtude e ko naatirta. E oon sahaa gooto, kala ƴiiƴam jibinaaɗo ina foti waɗde mbayliigu colour teskaangu gila e tar ɓaleejo ɓuuɓɗo (mekonium) haa e ƴiiƴam mbaylaandi ɓaleeri-boɗeeri, haa ñalnde 4 haa 5, mbaylaandi ndi yaltinta bilirubin gonɗo e ɓanndu.

No nganndirten so tawii ko ɓuuɓri super-absorbant jamaanu ina ɓuuɓi tigi¶

Paɗe ɓuuɓɗe jamaanu ina njogii polimeruuji gel poliakrilat sodium ɗi ɓuuɓnata ndiyam e yaawre haa ɓuuɓri ndernderi ndii ina yoori e toɓɓere hay caggal nde cukalel ngel ɓuuɓtii :

• Laabi kollitooji ɓuuɓri bulo: Ko ɓuri heewde e paɗe jibinannde ina njogii mbaydi ɓaleeri les ɓuuɓri yeeso yaajndi ndi waylata bulo walla ɓaleejo so jokkondirii e ƴiiƴam.
• Test teddeendi 3-kaɓirgal: Ƴeewee 45 mililiter (kaɓirgal 3 / 1,5 ons) ndiyam e nder ɓuuɓri laaɓndi, joorndi jibinannde keso, njogo-ɗaa ɗum e junngo maa; oon teddeendi squishy teskaa ko ko gooto "full wet diaper" nanata gila e ñalawma 5 haa yeeso.
• Feere kaayitaaji tissue (ngam paɗe ɓoornateeri walla paɗe ɗe ngonaa kollitooje): Waɗde kaayitaaji follaaɗi e tissue yeeso daneejo laaɓɗo walla kaayitaaji toilet e nder yeeso paɗe ɗee; so a udditii paɗe ɗee, ƴiiƴam ɗam ina waɗa hay ƴiiƴam tokosam ɗam ŋakkiraaka, ina laaɓti kala ko ina wona ɓuuɓri urate oraas-pink.

Seerndude "Brick Dust" Kiristaal Urate vs Pseudomenstruation Neonatal vs ƴiiƴam patoloji¶

Yiytude mbaydi oraas, pinndi, walla boɗeeri e nder paɗe cukalel keso ina hulɓina jibnaaɓe. Huutoro ndeeɗoo feccere safaara ngam seerndude fijirde jibinannde moƴƴere e ŋakkere ndiyam walla ƴiiƴam GI :

1. "Duɗɗude Birik" Kiristaal Asid Urik (Oraas, Rust, walla Salmon-Pink Taƴre Kalki):
2. Ko ɗum woni : Ɓiɓɓe jibnaaɓe ina njaltina asid urik toowɗo e nder ƴiiƴam mum en. So ƴiiƴam ina ɓuuɓtoo e nder balɗe kolostrum ɗe ɓuuɓri mum famɗi (Balɗe 1 haa 3), asid urik ina ɓuuɓtoo e nder ɓuuɓri mikroskoop, ina ɗacca taƴre ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, ɓuuɓnde, boɗeere-oraas walla rust-red e dow paddorde diaper (ina wayi no neɗɗo ɓuuɓnii e dow loope boɗeeje b).
3. So tawii ko no woorunoo vs. emergency: No woorunoo e Balɗe 1, 2, e 3. So a yiyii kiriis urate brick-dust e ñalawma 4 (caggal) walla ñalawma 5 e ko ɓuri ɗum, wonaa ƴiiƴam, ko maande classique wonde ƴiiƴam ɓiɗɗo oo ina heewi no feewi e underfeeding e dehydration. Noddu hannde doktoor sukaaɓe maa, ɓeydu heen kosam ɗoon e ɗoon.
4. Pseudomenstruation debbo jibinaaɗo (ɓuuɓri ɓaleeri mucoid e ƴiiƴam pink/boɗejam):
5. Ko ɗum woni: E nder rewɓe jibinaaɓe e nder balɗe 2 haa 7, ustaare ɓuuɓnde e nder reedu yumma toowndu e nder reedu mum caggal jibineede ina addana ɓiɗɗo oo ɓuuɓde e nder reedu mum tokooso, ina feeña no ɓuuɓri ɓaleeri-ɓuuɓri dark vaginal dark blod of b right mucus streak.
6. Ko foti waɗeede: 100 e nder teemedere ko huunde woowaande, nde alaa ko bonnata; ɓuuɓna no feewi gila yeeso haa caggal, woto meeɗ etaade ɓuuɓnude denndaangal vernix/mucus daneejo reenoowo oo gila hakkunde labia.
7. Nokkuuji ƴiiƴam patoloji ɗi njiɗi ko toppitaade ko yaawi (boɗeejo, ɓaleejo caggal ñalawma 5, walla ɓaleejo ɓuuɓɗo):
8. Ƴiiƴam boɗejam jalboojam e nder ƴiiƴam walla ƴiiƴam ɓalejam ɗam feeñata kadi caggal nde ƴiiƴam ɗam wayliima: Ina ɗaɓɓi ƴeewndo safaara yaawngo ngam anndude so tawii ko ƴiiƴam ŋakkiraaɗam Vitamin K (ñawu ƴiiƴam jibinaaɗo keso oo, haa teeŋti noon so tawii fiɓnde jibinannde Vitamin K ndee ina ustii ɓuuɓri ɓalndu.
9. Ɓoornugol danewol, ɓuuɓngol, walla ɓuuɓngol ɓuuɓngol (Ɓuuɓri Acholic): Ɓuuɓri Acholic): **Ɓuuɓri daneeji walla ɓuuɓndi e saraaji ɓuuɓri ɓaleeri ina jokki e duuɓi 2 ina hollita **atresia biliaire e dow opera- liver a time). (Portoenterostomie Kasai) ko adii balɗe 30 haa 60 nguurndam ngam haɗde ñawu nguu warde.

2. Jabet jibinaaɗo keso (Hiperbilirubinemie) e Haɓde e Kernikterus¶

Jaundice ko mbaydi ɓaleeri ɓalndu e ɓaleeri gite (icterus scleral) saabaade ɓeydagol ƴiiƴam bilirubin mo alaa ko jokkondiri (indirect), woni mbaydi ɓaleeri-oraas ndi so ɓanndu nduu ɓuuɓtii hemoglobin ummoraade e ƴiiƴam boɗejam ɓooyɗam. Sabu ɓiɗɗo nder reedu ina sokli ƴiiƴam mboɗejam ɓeydotooɗam ngam nawde oksijen, kadi ina jogii nguurndam ƴiiƴam mboɗejam ɓurɗam juutde (balɗe 70 haa 90 e balɗe 120 e nder mawɓe), kala jibinaaɗo ina jibina ina ɓuuɓna ƴiiƴam mboɗejam keewɗam tawi noon ko enzim heeriindi /DPAyl-transferron (1U UGT1A1) ina gollira tan e 1% e mbaawka mawɓe e nder balɗe gadane nguurndam.

Ko ɗum waɗi, 60 e nder teemedere e sukaaɓe jibinaaɓe e dumunna timmuɗo e 80 e nder teemedere e sukaaɓe jibnaaɓe ko yaawi walla ko juuti (aset 34 haa 37) ina keɓa jaaɓɗe fisiyoloji yiyteteeɗe hakkunde balɗe 2 e 5. Kono so tawii bilirubin mo alaa ko jokkondiri e mum ina ɓeydoo heewde ko ɓuri mg.2 above to 30p to 425 \(\mu\text{mol/L}\))** e nder cukalel ngel timmaani, walla e nder toɓɓe ɓurɗe lesɗude e nder cukalel ngel jibinaaka, ngel ñawɗo, walla ngel ƴiiƴam ABO/Rh (gangliaaji basal, globus pallidus, hippokampus, e ƴiye ngaandi nanɗe).

Ensefalopati bilirubin ɓuuɓɗo (ABE) e kernikterus : maale ñawu nguu e nder ɓalndu¶

Tooke ngaandi ummoraade e bilirubin toowɗo ina waɗa e daawe ɗiɗi : Ensefalopati bilirubin ɓuuɓɗo (ABE) (mo waawi waylude haa jooni so tawii safraama ɗoon e ɗoon e nder safrirde tawa ina waɗi fototerapi tiiɗɗo e mbayliigu ƴiiƴam) e Kernicterus (desensoriin, paltheebur, duumotooɗo ɓuuɓri gite dow, e ɓuuɓri dental).

No ƴeewndortee ƴellitaare jabet e nder galle : Zoneeji Cephalocaudal (Hoore haa Koyɗe) Kramer¶

Jabet jibinaaɗo keso ina famɗi ɗo yaaji gila e hoore haa e koyɗe (progression cephalocaudal) nde bilirubin ƴiiƴam ɓeydotoo. So tawii ƴeewndo yiytere meeɗaa lomtaade opitaal Bilirubinometre transcutanée (TcB) ƴeewndo walla Bilirubine sérum total (TSB) ƴeewndo ƴiiƴam taƴre (haa teeŋti e cukalel ngel ɓalli mum en ɓuri ɓallaade, ɗo foti ƴeewndaade **daneeji gite, so palms e sclera . Kuulal Kramer ina rokka limto tiiɗngo to bannge leeso:

Geɗe 5 ɓurɗe teeŋtude ɗe mbaɗata ɓuuɓri jibinannde ina njaawna laabi ɗiɗi¶

Habrirde cafroowo walla doktoor sukaaɓe ɗoon e ɗoon so tawii cukalel maa ina jogii heen huunde e ɗeeɗoo tookeeji walla hemolisis (ko ɗum siforaa e 2022 Akademi Ameriknaajo toppitiiɗo ko fayti e safaara sukaaɓe [AAP] : Kuulal 2022 ngam ƴellitde safaara hiperbilirubinemia):

1. Jaundice feeñata e nder waktuuji 24 gadani nguurndam: Pathologique haa selli ko wonaa ɗuum. Fotde sahaa kala ina addana ɗum ustude jaawgol ƴiiƴam mboɗejam (hemolyse) ummoraade e ŋakkere ƴiiƴam ABO (yumma ko ƴiiƴam O e cukalel ko ñawu AGR walla B ŋakkeende.
2. Duuɓi jibinannde cakkitiiɗi walla puɗɗiiɗi (34 haa 38 yontere): Cukalel jibinaaɗo e yontere 35, 36, walla 37 ("ɓiɗɗo jibinannde / duuɓi cakkitiiɗi") ina jogii heeñere nde timmaani AND ɓuuɓri/jawdi ɓurndi leelde ina suusa ɗum ko adii nde ina ɓuuɓna ɓe laabi ɗiɗi risk** hiperbilirubinemiya tiiɗɗo e ŋakkeende ndiyam so yerondiraama e cukalel ngel duuɓi 40.
3. Cephalohematoma walla ɓuuɓri jibinannde mawndi: So tawii ƴettugol vacuum, pinngi, walla jibinannde tiiɗnde addi ɓuuɓri ƴiiƴam softunde mawndi e dow hoore ɓiɗɗo oo (cephalohematoma) walla ɓuuɓri yeeso/ɓanndu, ɓanndu ɓiɗɗo oo ina foti ɓuuɓnude kala ko ina ɓuuɓna Daysve2 e bilirubin e nder ƴiiƴam.
4. G6PD (Glucose-6-Fosphate Dehydrogenase) ŋakkeende: ŋakkeende enzim gonɗo e X (ɓuri heewde e galleeji iwdi Afrik, Mediteraane, Fuɗnaange hakkundeejo, e Asii fuɗnaange-rewo) ɗo ƴiiƴam mboɗejam ɓuuɓtata ɗoon e ɗoon e nder ƴiiƴam ɓuuɓɗam comci jibinannde keso haa e ɓuuɓri [naftalin], e mbaydi henndu, walla e ɓiɗɓe leɗɗe fava**).
5. Njaram ɓuuɓɗam ("Heege / Jaundice mo ŋakkere ñamri"): So cukalel ngel heɓaani kosam no haanirta nii e nder balɗe 3 haa 5 gadane ɗee, njillu nguu ina leeltina. E nder ɓalndu ɓuuɓndu, enzim biyeteeɗo \(\beta\)-glukuronidase ina ƴetta bilirubin e nder ɓalndu, nelda ɗum ɗoon e ɗoon e nder ƴiiƴam cukalel ngel (cirkulaasiyoŋ enterohepatik).

Ko waɗi aɗa foti MEƊƊUDE waɗde ɓiɗɗo keso mo ƴiiƴam mum ɓuuɓɗam e nder lewru¶

Yontaaji mawɓe ina mbiyatnoo yo mbaɗtu ɓiɗɗo gorko daneejo seeɗa e dow ŋoral yeeso feɗeendu naange. Akademi Ameriknaajo ko faati e safaara sukaaɓe (AAP) e jamirooje NICE to leydi Angalteer ina njeertina laaɓndal huutoraade lewru naange to galle ngam ñawu nguu jibinaaɗo keso:

• Annoore naange toownde walla filtoraande e windo ina addana cukalel jibinaaɗo keso oo hipotermi (e nder suudu ɓuuɓndu) walla hipertermi e ɓuuɓri naange UV tiiɗndi e nder hojomaaji 15.
• Tuugnaade e windo ina leeltina jibnaaɓe heɓde ƴeewndo ƴiiƴam Total Bilirubin Serum (TSB) tawa bilirubin ina ɓeydoo 20 mg/dL.
• No fototerapi safaara goonga oo gollortoo: Opitaaluuji (e paddorde fibre optik Biliblanket galleeji) ina kuutoroo annoore LED buloore to 460 haa 490 nanomeeteer, nde naatata e ɓalndu, nde foto-isomerize e nder a**mirubin-soluble unjuconjubin molekul ɓuuɓɗo ndiyam mo ƴiiƴam cukalel ngel e heeñere mum mbaawi yaltinde e nder ƴiiƴam e ƴiiƴam mum tawa alaa ko haani e enzim heeñere.

3. Ƴeewtaade Letargy jibinaaɗo keso vs. ɗanngal no woorunoo (e no ɓiɗɗo ɗaaniiɗo umminirtee ngam ñamminde)¶

Jibinaaɓe ina keewi ɗaanaade waktuuji 16 haa 18 e ñalawma e nder balɗe juutɗe, waktuuji 2 haa 3. Kono, nde tawnoo dehydration (sodium toowɗo e nder ƴiiƴam) e bilirubin toowɗo fof ina mbaɗa sedatives naftooje e ngaandi cukalel, cukalel gonngel e heege walla ngel ɓuuɓngel woyataa e heege, e oon sahaa, ɓe ɓeydoo deeƴde, ɓe ɓeydoo ɗaanaade, ɓe ɓeydoo saɗtude umminde ("the" traleep).

Porotokol ɗaɗol ngam umminde cukalel ɗaaniiɗo (kono mo ŋakkiraaka) ngam ñamminde waktuuji 2 haa 3 kala¶

E nder balɗe 10 haa 14 gadane nguurndam, haa nde ɓiɗɗo maa heɓi 100 e nder teemedere teddeendi jibinannde mum, tawa kadi ko ñawu nguu ina safra, woto meeɗ ɗaanaade ɓiɗɗo jibinaaɗo ko ɓuri waktuuji 3 e nder ñalawma walla waktuuji 3,5 haa 4 laawol gootol jamma tawa o ñamlaani (8 haa 124 hours feeds):

1. Daɗndu faɗo ɗanngal Active (REM): Yiylo gite ɓuuɓɗe, ɓuuɓɗe koppi, walla dille ɓuuɓɗe hade maa ƴettude ɓiɗɗo oo.
2. Strip ɓiɗɗo les haa diaper maɓɓe tan: Ɓoornugol e ɓuuɓri ɓuuɓndi ina waɗa sukaaɓe jibnaaɓe keso ɓee haa laaɓa cer. Ɓoornu ɓiɗɗo oo, mbaɗa ɗum laral-to-laral e dow ɓanndu maa ndu alaa ko woni e mum.
3. Waylude paɗe e huutoraade stimulation tactile double: Waylude paɗe ina ummina ko ɓuri heewde e sukaaɓe. Ƴeewee ɓalndu ɓiɗɗo oo, ƴiyal mum, e koyɗe mum no feewi, walla ɓuuɓnu tiinde mum e wuttulo mum no feewi e lootorde ɓuuɓnde (nde wonaa ɓuuɓnde).
4. Hollitde toɓɓere colostrum/kosam e dow hunuko ɓiɗɗo oo e waɗde ɓuuɓri e nder reedu nde o ɓuuɓnata: So a lattii, ɓuuɓna reedu nduu no feewi to les kala nde ɓiɗɗo oo ɓuuɓnata ngam ɓuuɓnude ɓuuɓri kosam e nder hunuko mum e jokkude ɓuuɓnude ɗum. (So tawii ɓiɗɗo oo waawaa ŋoŋɗude fotde hojomaaji 5 hay so tawii ko ɗeeɗoo geɗe, darto, yah to safrirde too).

4. Banngeeji boɗeeji goɗɗi e nder yontere adannde ndee : ɓuuɓri ɓaleeri, ɓuuɓri ƴiiƴam, e fooftere¶

Gaa gaa ŋakkere ndiyam e ɓuuɓri, maale tati ɓeydooje e ɓanndu e nder yontere adannde ndee ina ɗaɓɓi ƴeewndo ko yaawi :

1. Bilious (Haako-haako-haako-haako ɓaleejo) Ɓuuɓri: Emergency seppo:
2. Normal Spit-Up: Ndiyam danejam walla danejam ɓuuɓɗam ina yalta e ŋoral hunduko tawa alaa ko bonnata ɗum caggal nde ɓuuɓri.
3. Pyloric Stenosis (Ko heewi ko yontere 2 haa 8): Ɓuuɓri "projectile" doole kosam ɗam/ɓuuɓɗam fiyde e nder suudu nduu caggal nde ñamlaa (ina haani ƴeewteede ko yaawi).
4. Malrotation avec Midgut Volvulus (Ɓuuɓri ɓaleeri / ɓaleeri neon e kala ñalawma nguurndam): So tawii cukalel ngel ina ɓuuɓtoo ndiyam nannduɗam e haako-haako-ñebbe neon, walla ɓalewol ladde ɓalewol (bile), ina gasa tawa ɓalndu tokoosru nduu ina ɓuuɓtoo e sara ƴiiƴam mum mawɗam (**the mesenteric superieur). Ɗum ko emergency surgical nguurndam walla maayde : woppude ñamri ɗoon e ɗoon, yah to Departemaa Emergency Hospitaal Sukaaɓe hade ɓalndu ɓuuɓndu nduu maayde.
5. Omfalitis (Bakteriiji gonɗi e ɓuuɓri ƴiiƴam):
6. So tawii ɓuuɓri ƴiiƴam cellundi ina waawi hollirde toɓɓere ƴiiƴam yoornde walla uurngol seeɗa no feewi nde ɓuuɓnata hakkunde balɗe 7 e 14, yaajde boɗewol, nguleeki, ɓuuɓri, walla ɓuuɓri e dow ɓalndu reedu saraaji ɓuuɓri ƴiiƴam, walla oophalitis ɓuuɓɗo ɓuuɓɗo ummoraade e**ompus is Sabu ƴiiƴam ɗam ina jokkondiri no feewi e heeñere cukalel ngel e reedu mum, omfalitis ina waawi saabaade sepsis neonatal fatal e fasciitis nekrotisan e nder waktuuji seeɗa, ina ɗaɓɓi kadi antibiotik IV ko yaawi e nder ER.
7. Caɗeele fooftere e Apnea:
8. Limtu foofaango ɓiɗɗo maa fotde leƴƴanɗe 60 timmuɗe tawa ina deeƴi (ɓiɗɗo jibinaaɗo oo ina foofa e mbaadi "fooftere sahaa" nde aldaa e sago, tawa ina foofa leƴƴanɗe 5 haa 10 seeɗa). Noddu 911 / 112 / 999 ɗoon e ɗoon ngam fofde duumiinde ɓurnde yaawde e 60 fooftere e nder hojomaaji, poofgol apnee duumotoongol leƴƴanɗe 20 walla ko ɓuri ɗum, retractions intercostales walla subcostales (kosam ina suuɗa haa juuta les ƴiye walla ƴiye ɓalndu), **fofde sal,**dogde colour blue/gray ɗemngal e leppi.

Naamne keewɗe naamneede¶

Hol ko waɗi ɓiɗɗo am keso mo balɗe 2 ina ɗacca ɓuuɓri oraas walla pinki-boɗeeri e nder diaper? Mbele ko ƴiiƴam?¶

Ñalɗi 1, 2, e 3 nguurndam, ɓuuɓri oraas, ɓuuɓri, walla salmon-pink e nder paɗe jibinaaɗo keso oo, ko famɗi fof ko "brick dust" urate crystals, kiristaal asid uric mo alaa ko bonnata, mo yaltata e ƴiiƴam jibinaaɗo keso oo, tawa ina fadi haa yumma oo mawna e nder ñalnde4 sukaaɓe rewɓe jibinaaɓe, ƴiiƴam boɗejam tokosam e nder ƴiiƴam danejam tiiɗɗam e nder yontere adannde ndee kadi ko "pseudomenstruation" no woorunoo ummoraade e ittugol hormon yumma). Kono so a yiyii kiristaaluuji urate brick-dust oraas e ñalawma 5 walla caggal mum, ɗum firti ko ƴiiƴam ɓiɗɗo oo ina heewi no feewi sabu ŋakkeende ndiyam e ŋakkeende nguura, ina ɗaɓɓi ƴeewndo sukaaɓe ñalnde heen e ñamri ɓeydundi ɗoon e ɗoon.

Hol no mbaawirmi anndude ko seerndi mboros jibinaaɗo keso oo e mboros bonɗo?¶

Wakkati, yahdu ɓanndu, e jeertinaango ɓinngel ɗon sendi ɗi ɗiɗi. Jabet fisiyoloji no woorunoo meeɗaa feeñde e waktuuji 24 gadani nguurndam ; ina fuɗɗoo hedde ñalawma 2 walla 3 e yeeso e ɓalndu toowndu, ina tolnoo e ñalawma 3 haa 5, ɓiɗɗo oo ina ummoo e yarlitaare kala waktuuji 2 haa 3 ngam ñamminde, ina yaltina kadi paɗe aawdiiji ɓuuɓɗi e boɗeeji keewɗi. Jaundice ko emergency safaara ko yaawi so tawii (1) ɓalndu walla gite daneeje peeñii e nder waktuuji 24 gadani caggal jibineede, (2) mbaydi oole ina saɗta les rewde reedu haa e les koyɗe, e juuɗe, walla e koyɗe koyɗe, (3) ɓiɗɗo oo ina leƴƴi, ina waawi a feedschird to or caggal, walla (4) ɓuuɓri ina juuta ko ɓuri jonte 2 e ɓuuɓri ɓaleeri/boɗeeri.

Mbele miɗo waawi waɗde ɓiɗɗo am keso mo mboros oo yani oo sara feɗeendu naange walla miɗo rokka ɗum ɓuuɓri ndiyam ngam yaltinde bilirubin oo ?¶

Hoto meeɗ waɗde heen kadi. Hokkude cukalel ngel ndiyam laaɓɗam walla ndiyam suukara, yaltintaa bilirubin (ko ɓuri heewde e leɗɗe bilirubin e nder reedu rewrude e ñaamdu kosam keewɗam kaloriiji, wonaa ndiyam) ina waawi kadi saabaade ŋakkeende sodium e nder ƴiiƴam (seerndude ɓuuɓri ndiyam) tawa ina hebbina reedu cukalel tokosel ngel kaloriiji ɗi ngalaa. Ko noon kadi, Akademi Ameriknaajo toppitiiɗo ko fayti e sukaaɓe ina jeertina waɗde cukalel keso ngel alaa comci e nder naange toownge walla e nder windo, sabu baasal mawngal, nguleeki ɓurtuki, ɓuuɓri naange, e leelgol kulɓiniingol heɓde ƴeewndo ƴiiƴam bilirubin laaɓtungo e nder safrirde e fototerapi LED blue mo tolno safaara.

Hol ko waɗi ɓuuɓri ɓaleeri e nder cukalel keso ina wona caɗeele teeŋtuɗe so yerondiraama e ɓuuɓri ɓaleeri ?¶

Fotde sukaaɓe jibnaaɓe ɓee fof ina njuppa kosam ɗam seeɗa e kosam danejam walla kosam ɗam ɓuuɓɗam caggal nde njippii sabu ɓuuɓri ɓalndu to dow reedu mum en ina ŋakki. Kono so tawii cukalel ngel ina ɓuuɓna ndiyam ɓuuɓɗam, ɓuuɓɗam neon, walla ɓuuɓɗam ɓuuɓɗam (ɓuuɓri bile), ɗum firti ko bile ummoriiɗo e ƴiiƴam ina ruttoo e nder reedu sabu ɓuuɓri les ɓuuɓri bile. E nder cukalel keso, ɓuuɓri ɓaleeri ko maande ɓooynde e malrotaasiyoŋ ɓalndu e midgut volvulus, ko ɓuuɓri seppo ɗo ɓalndu ɓuuɓndu taƴata e ƴiiƴam mum, ina waawi maayde e nder waktuuji seeɗa so wonaa tawa seppo sukaaɓe ɓuuɓnaani ɗum.

Fuɗɗoode ƴeewtaama¶

• Akademi Ameriknaajo ko faati e safaara sukaaɓe (AAP, Amerik) : Rewindaade kuule kuutoragol safaara : njuɓɓudi hiperbilirubinemiya e nder cukalel jibinaaɗo e nder yontereeji 35 walla ko ɓuri ɗum (Kemper et al., Pediatrics, 2022).
• Duɗal ngenndiwal ngam cellal e toppitagol (NICE Guideline CG98 & NG194, Royaume-Uni): Jaaɓngal e nder sukaaɓe jibinaaɓe e nder balɗe 28: Anndinde, Bilirubinometri transkutane, e Fototerapi e Toppitagol caggal jibineede.
• Fedde Adunaare Cellal (OMS): Deftere Pocket toppitagol sukaaɓe e opitaal: Laabi ngam haɓaade ñawuuji sukaaɓe keewɗi: Jaaɓnirɗe sukaaɓe jibinaaɓe, ŋakkeende ndiyam, e maale kulɓiniiɗe.
• Akademi safaara ñamri (ABM Clinical Protocol #3 & #22): Ɓeydagol ñamri e nder dumunna celluɗo sukaaɓe ñamlaaɓe, limtooji teddeendi, e njuɓɓudi hiperbilirubinemiya sukaaɓe.
• Fedde sukaaɓe Kanadaa (CPS): Laabi ngam yiytude, ƴellitde, e haɗde hiperbilirubinemiya e nder sukaaɓe jibinaaɓe e sahaa mum en e sahaa mum en.

Ardiiɓe jokkondirɓe¶

• Emergency safaara caggal jibineede e maandeeji kulɓiniiɗi jibinannde keso
• Psychose caggal jibineede e depression caggal jibineede : caɗeele hakkille perinatal
• Cukalel toowngel nguleeki e ɓuuɓri ɓuuɓri
• Ɗaɗi ɓuuɓɗi (sinkope bulo vs. pale) e triage apnée cukalel
• Ɓooygol kosam ɓiɗɗo, taƴgol yiite, kosam ɓiɗɗo, e ñamminde moƴƴere
• Limooje emergency e leydi