Medical supervision and treatments in special situations

Neonatal Jaundice
Jaundice in newborns is a common phenomenon appearing in about 60% of babies. It is not an infection or an infectious disease, but the disassembly of red blood cells which exist in high levels in newborns, which in turn causes the creation of a yellow pigment called Bilirubin. This substance creates the yellow shade of the skin and the white of the eye. Bilirubin changes in the liver and is extracted from the body through urine and feces.

Bilirubin levels are checked by the nurses with a device attached to the skin, usually on the forehead. The results are immediate and do not cause pain. another way of testing is through a blood test, with blood taken from the heel of the foor. We redo the tests every few hours in a baby that developed jaundice.

Mostly, Bilirubin levels will stay in a range that does not cause any damage or cause danger to the baby, and the baby only needs medical supervision, without treatment. The decision to begin treatment to lower Bilirubin levels depends on the age of the baby, his weight and physical maturity, and other medical factors. If Bilirubin values reach the treatment threshold, it can be treated with light therapy: The baby lays under the blue light with only a diaper and an eye shielder. With this treatment, following the jaundice and the baby's body temperature continues.

In the "flexible rooming-in" departments, the phototherapy is performed in the nurseries, and in the "complete rooming-in" department it is done next to the mother's bed in the hospitalization room.

Fever supervision
In cases of continuous water breaking before the birth, if the mother has a fever around the time of birth, if there is suspicion of infection in the amniotic fluid, or if the mother is a carrier of the Strep B bacteria (a type of bacteria which resides in the woman's cervix and the lower digestive tract), the baby is put on fever supervision. His fever will be checked every few hours, and according to the baby's status and the medical data collected, the baby might recieve treatment.

Tongue-tie is a congenital condition in which the bottom of the tongue is connected to the floor of the mouth by a gentle membrane string. This can cause the baby problems with his tongue movement, sometimes to the point of interrupting breastfeeding. This can be identified by the nurses, the breastfeeding consultants, and the neonatologists.

When it is meaningful, the breastfeeding mothers will usually feel pain in the nipple during breastfeeding and the nipples will become chafed and injured. The breasts will also be swolen because since the baby has trouble feeding, there will be of excess milk. This can also cause a decrease in milk production in the mother. Situations in which there is a disturbance to breastfeeding, the baby will be referred to a pediatric surgeon or a mouth and jaw surgeon to undergo cutting of the frenulum. This is a quick procedure without any need for anesthesia. A light bleeding is possible and you can immediately breastfeed the baby in the presence of a nurse or a breastfeeding consultant.

Torticollis ("Wry Neck")
Torticollis is a condition in which we will see the baby's neck tilted to one side involuntarily, while the chin faces the other way. This phenomenon is usually related to the position of the head and the neck when the baby was inside the womb during pregnancy or birth. In most cases Torticollis passes on it's own and it can also be treated by practicing turning the baby's head to the opposite side.

Congenital Hip Dysplasia
There can be many varied causes for this condition, usually related to either genetic and environmental factors.

Congenital hip dysplasia is more common in females. The risk factors include family history, wideness of the bottom before birth, multi-fetus pregnancies, a relatively small amount of amniotic fluid and signs of in-uterus pressure.

Early identification of an unstable joint is usually done by the neonatologist in the baby's first phyiscal examination. Discovery and early treatment allows normal development and prevention of handicap later in life. According to the examination results the baby is examined by a pediatric orthopedist and appropriate treatment is decided upon (such as putting two diapers on the baby, using special belts and more). The follow-up on Hip Dysplasia includes hip-joint ultrasound at one month old and a returning inspection with a pediatric orthopedist.