Cheer up buttercup

Author: Fiona Mendes / Editor: Yasmin Sultan / Codes: HCPS4i / Published: 02/09/2019

A 38-year-old mother presents with her 2-day-old twin daughters, named Primrose and Marigold. They were advised to attend the paediatric emergency department due to neonatal jaundice noticed by their community midwife.

The first-time parents show you their red baby books and you confirm with them that it was an in vitro fertilisation (IVF) conception. Both parents are well. The mother has well controlled diabetes mellitus and had two previous early miscarriages. The twins were born at 36 weeks gestation, by a planned and uneventful caesarean section delivery. Both twins had normal baby checks at birth and before their discharge home yesterday.

Both neonates have been breast feeding on demand every 2-3 hours.

Both neonates have yellow skin discoloration. Weight, stools, urine output, and examination are normal and the neonates are both otherwise well.

Primrose (twin 1) appears to be more jaundiced than Marigold (twin 2) and has a higher bilirubin level. After being assessed, Primrose (twin 1) is admitted to the post-natal ward for phototherapy.

Based on your assessment, you believe that these twins are well neonates with physiological jaundice.

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