Brief Answer:
Fever can be environmental if baby is otherwise active

Detailed Answer:

Hello,

Most common cause of mild fever in this age is warm environment or over-clothing.

I won't get worried if baby is otherwise active, accepting feeds well, passing urine/stool normally and there is no rapid breathing, any cough, abdominal distension or any other significant problems.

I would suggest you to maintain the room temperature around 27-29 degree Celsius, avoid over-clothing, to give frequent feeds and observe closely for any significant abnormality or persistence of fever.

If you notice any problem please consult your pediatrician for proper evaluation.

I hope this helps. Please let me know if you have any more queries.

Regards,
Dr. Pradeep Kumar
Pediatrician, Cardiology

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Brief Answer:
Let me know the thyroid report and blood group of the baby

Detailed Answer:

Hi,

The bilirubin level on 7th Feb was 9 and it is 11 today. The weight gain is normal as all babies loose weight (about 10%)of birth weight during first 7 days and there after gain weight at an average rate of 25-30 gm/day.

The common causes of raised bilirubin in this age are blood group mismatch, hypothyroidism and poor feeding. Although the value of 11 is not very high for this age and also does not causes any harm to the baby, I would like to know if the thyroid test of the baby has been done and also the blood group of both mother and baby. As the weight gain is proper I assume that poor feeding is not the cause of raised bilirubin.

Also, let me know about the feed of the baby as babies on exclusive breast feed may have persistent raised bilirubin may be upto 6 weeks. Don't get much worried about the bilirubin report and please provide me details so that I better able to help you out.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Pradeep Kumar
Pediatician, Cardiology

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Brief Answer:
To me it appears to be breast milk jaundice for now

Detailed Answer:

Hello,

Apart from bilirubin level, all reports are normal also as per the blood group possibility of blood group incompatibility is ruled out.

After reviewing everything, to me it appears to be breast milk jaundice as per now.

I would suggest you not get worried and get a repeat bilirubin test done after few days after discussion with your pediatrician. If repeat bilirubin remains high few investigations to rule out other less commoner causes like G6PD deficiency or liver function derangement.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Pradeep Kumar
Pediatrician, Cardiology

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Brief Answer:
Report shows G6PD deficiency

Detailed Answer:

Hi

The quantitative value of G6PD is low as shown in the report. G6PD deficiency can lead to breakage of red blood cell and thus increased serum bilirubin.

As this test is not always confirmatory so once the quantitative test is positive thorough investigation should be done to confirm the diagnosis and to assess the severity of condition.

Here further investigations like complete blood count(to see hemoglobin, RBC, total leukocyte count), reticulocyte count(to see the RBC breakage), genetic test of G6PD deficiency should be done.

There are so many variant of G6PD deficiency with varying severity and thus genetic test helps in such condition.
If the diagnosis is confirmed then you should know the list of conditions, food items or drugs which may precipitate the G6PD deficiency. Avoidance of all these helps in leading a normal life.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Pradeep Kumar
Pediatrician, Cardiology

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Brief Answer:
CBC and reticulocyte count is normal

Detailed Answer:

Hi,

I have seen both the CBC and reticulocyte count and both are normal. You may find some of the parameters out of range (highlighted too) but that is not much significant.

I just want to brief you something to alleviate your anxiety and also to make you more relaxed. Actually G6PD is an enzyme glucose 6 phosphate dehydrogenase and decreased level of this enzyme causes increased breakdown of red blood cell which leads to increased bilirubin (Bilirubin in body is formed by breakdown of RBCs).

Reticulocyte count helps in evaluation of increased breakage of RBC as it gets elevated in such condition. In your baby's report there is raised bilirubin and decreased G6PD level but this does not suggests that this raised bilirubin is due to RBC breakdown as the RBC count, hemoglobin and reticulocyte count all are normal.

So although there is decreased G6PD level but don't get overly worried for this as it is not creating any problem right now.
I would suggest you to get repeat G6PD level done after 3 months and avoid all precipitating factor that may worsen the condition.

Hope I have answered your query. Let me know if I can assist you further.

Thank you. All the best.

Regards,
Dr. Pradeep Kumar
Pediatrician, Cardiology

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Brief Answer:
My best wishes are with you and your family

Detailed Answer:

Hello,

It's my pleasure that you found my suggestions helpful. My best wishes are with you and your family.

Regards,
Dr. Pradeep Kumar
Pediatrician, Cardiology

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