Talia

'This baby will give you trouble, Susan!' the Paediatrician declared.

Talia? That little bundle of baby girl sweetness? Trouble?

Sometimes when medical people talk about 'trouble' we are actually describing a patient who presents us with a clinical challenge.

Talia had a deep red colour when she arrived at God's Littlest Angels, the day before. She was 13 days old and the whites of her eyes were yellow. This was a sure sign of jaundice - a condition that occurs when bilirubin levels rise. Bilirubin is a pigment in red blood cells. Sometimes, newborns' livers cannot excrete bilirubin in the first week or so of life and the rising levels of bilirubin stain the skin. Jaundice has to be monitored - high levels of bilirubin can cause brain damage.Although I was concerned to see Jaundice in a 2 week old baby, wondering if this was caused by something other than just an immature liver, by the time the baby saw the Paediatrician the next morning I was not as worried as the Doctor.

 In early December, our orphanage Director arrived in Haiti with donated equipment from a US based medical supply company called Children's Medical Ventures. One of the pieces of donated equipment was a transcutanous bilirubin monitor. This made it possible for us to immediately screen baby Talia, using a painless test to determine whether her  jaundice level was an immediate threat to her health. We already knew that it was not. We had already tested a few drops of Talia's blood, and determined that she had a very high level of red cells in her blood. We had also done a bedside test that screened Talia for signs of infection. That test had been negative.

Over the days that followed, we monitored Talia's bilirubin levels, and observed her carefully. The Paediatrician was pleased by my report that the bilirubin levels were falling, and that Talia was waking for her feeds, tolerating them well, breathing normally and peeing and pooping regularly. The most likely cause of this baby's high bilirubin was delayed clamping of the umbilical cord. The extra cells would have made her blood more viscous and this could have caused breathing problems, as well as damage to her brain and kidneys.

All the signs indicated that although Talia had not had access to medical care, she hadn't suffered any complications. Her condition was temporary and it was resolving. I peeked at her, sleping peacefully in her box crib. I sighed softly, letting the last remnants of the concern I had harboured for her slip away. I am a Paediatric Nurse. I see lots of sick newborns. Lots of newborns with problems. It is always a blessing and a relief to look upon a  beautiful healthy baby.

Talia is no trouble at all........at this point in her life ;-)