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Salting Newborns, Ghofran, Flat Isoelectric Record, Volume Exchange Transfusion, Phototherapy, Severe Hyperbilirubinemia, Urine Analysis, Mixed Growth, Rubbing Skin, Preliminary Results. The word pediatrics and its cognates mean healer of children; they derive from two Greek words: παῖς (pais = child) and ἰατρός (iatros = doctor or healer). THis is one of lectures on Paediatrics. Main points are give above.
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Some traditional practices regarding newborn care, had been followed since few thousands of years, generation after generation. Some of these
practices are useful , some are potentially harmful , and some
are killing.
Salting newborn babies is one of the traditions that started since several thousands of years ago, since the Greeks and the Romans. A practice which continued after Judaism and Christianity in various forms and names. Baptism probably is a continuation or a modification of these practices. Salting babies is also practiced in Japan and many other countries.
Nothing in Islam is with or against Salting babies, but this habit is still practiced in most of the Arab countries. Unfortunately it is still widely practiced by various sectors of the population in Jordan.
During the last year four salted babies presented to our clinic, three of them required admission to the hospital, one of them died.
Case 1: Ghofran cont.
Investigations: Severe hypernatremia ( Na 194 mmol/l), renal insult (urea 39 mg/dl, creatinine 2.2 mg/dl), and severe metabolic acidosis( PH 7.04, PCO2 16.8, B.Ex –16 ). CSF Analysis:WBC 2,100% Lymph-RBC 17590 Fresh-Prn 700-Sug 380/ serum. Sepsis workup was done and then she was started immediately on I.V. antibiotics, fluids, and dopamine. ALL Cultures were negative. She developed intractable and repetitive attacks of convulsions that didn’t respond to conventional anticonvulsant. Brain CT revealed brain edema, intraventricular and subarachnoid hemorrhage.
Case 1: Ghofran cont.
In spite of all supportive measures and mechanical ventilation, she deteriorated steadily with an increase in the pressure of the anterior fontanel.
EEG showed a flat isoelectric record.
She died after 13 days.
Ghofran was salted by rubbing her skin with salt & oil, wrapping her daily and rubbing salt into her mouth.
AHMAD presented to Jordan Hospital clinic at two weeks of age with severe skin scarring after being salted daily for 3 days with salt & oil. At time of presentation physical examination was normal except for the skin manifestation. Head circumference was 36 Cm.
Case 4 - Sultan
Sultan was admitted to J H at the age of 5 days : Presented with fever , hypoactivity, and jaundice. Examination:Jaundice&poor moro reflex with no focus of infection apparently. Sepsis workup was done and antibiotics, fluids, and phototherapy were started. Investigations proved to have meningitis, wbc count 246, 60% Neutrophils , protein 85 mg/dl, Glucose 29 mg/dl. Urine Analysis:WBC 54,RBC 8,Prn&Sug Nil.Repeated:WBC 4. Urine C&S:Klebsiella Pneumoniae. Serum Na 142mmol/l.
Sultan was salted by rubbing skin with salt and oil.
One of the physicians interviewed the mothers and filled the questioner first.
112 mothers in the maternity ward were interviewed during one month which constitute all the deliveries except 4 mothers who were missed.
After completing the questions, the mothers were given an educational pamphlet explaining possible dangers of salting and the complications of hypernatremia and its signs and symptoms.
Maternal age: range 20-42 years old.
78 mothers (70%) knew about salting.
34 mothers (30%) never heard about salting.
48 mothers (43%) had been salted themselves as newborns.
37 mothers (47%) salted their babies at least once.
Of these, 17 (46%) university / college graduates. 20 (54%) high school or lower education.
Bathing and washing with salted water: 23 mothers (29%).
Rubbing skin with salt and olive oil: 29 mothers (37%).
Putting salt into the mouth / rubbing the tongue: 1 mother (2.7%).
25 mothers (30%) heard about it but do not know how.
Traditional Practice of Salting Newborns Conclusions
Salting newborns should be stopped to eliminate its possible morbidity and mortality. Adequate education of all mothers regarding the proper care of newborns is a must in all sectors. A multi-center campaign in collaboration with the Ministry of Health should be started to educate all the delivering women about salting and many other harmful practices like Kohl.
Pickling Babies Is Killing Babies
Educational campaign in the schools, colleges and universities.
Educational campaign using all the news media: newspapers, TV and radio. Posters in the public places. Educational pamphlets with simple information.