A male baby born at term to O -ve mother with Coombs +ve at delivery.Baby weighed 3 kg at bih and haemoglobinis 16 g/dL and TSB is 5 mg/dL. He passed a black stools within the first 24 hours of life and his temp was 97.7degF. After 5 days, infant's weight reduced by 60 gm, his axillary temperature reduced to 95degFand he is jaundiced upto the chest. Parents also told about yellow, seedy stool. Lab investigations show hemoglobin is now 14.4 g/dL, and his TSB is 14 mg/dL. The change in which of the following parameters is of most concern for you as a paediatrician?
In a normal infant, Temperature should not change. Temperature instability in a term infant is frequently a sign of serious infection. There is loss of body weight of 1.5% to 2% per day initially in a normal newborn infant as excessive fluid is excreted. The hematocrit falls as an adaptation to an environment of higher oxygen. Infants usually have several meconium stools during the first day or two of life, changing to soft yellow stools after 1 to 2 days of life. As the hematocrit falls, there is a corresponding increase in serum bilirubin that peaks around 3 to 5 days of life.
Hemoglobin
Temperature
Bilirubin
Stool
Neonatal sepsis