Management of Neonatal Jaundice during Initial Health Care Visit

Abstract

Backgrounds: Cholestasis is a bile flow disorder resulting in liver bile retention. It is characterized by intrahepatic (IH) and extrahepatic (EH) cholestasis. Health workers are strategically placed to provide correct information in managing patients with cholestasis. This study aimed to assess the management of neonatal jaundice during initial health care visit. Methods: A cross-sectional study was conducted on infants with cholestasis treated at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Questionnaires as data collection instruments were used. Statistical analysis was performed using Pearson's chi-square test. Results: Subjects consisted of 40 (58%) infants boys, 29 (42%) infants girls, IH cholestasis were 28 (41%), and EH cholestasis were 41 (59%). In both groups, most infants with cholestasis sought medical care between 0 and 1 month. Health workers stated that most subjects were underfed, as indicated by the 14 (20%) intrahepatic and 26 (38%) extrahepatic subjects. In this study, most infants with cholestasis were advised to get sun exposure. Sun exposure began at birth in 21 (30%) intrahepatic and 36 (52%) extrahepatic subjects. There were no significant differences based on underfeeding and sun exposure between the intrahepatic and extrahepatic cholestasis groups (p=0.268; p = 0.168). Conclusion: The management of neonatal jaundice among health workers regarding breastfeeding and sun exposure recommendations did not significantly differ between intrahepatic and extrahepatic cholestasis. Health workers require more knowledge about cholestasis infant management. Correct understanding improves cholestasis infants' outcomes.