🎯 Learning Objectives
By the end of this lesson, learners will be able to:
✅ Explain how severe or untreated jaundice affects brain areas linked to feeding, hearing, and learning
✅ Monitor newborns and infants for related problems
✅ Know where and when to refer for support
🧠 How Jaundice Affects a Baby’s Development
When jaundice becomes severe and is not treated in time, high levels of bilirubin enter the baby’s brain and damage certain areas—especially those that control:
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Feeding and sucking
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Hearing
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Movement and coordination
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Memory and learning
This damage is called kernicterus (see Lesson 9.1). It can cause lifelong disabilities.
🍼 Feeding Difficulties from Jaundice
What to Look For:
| Age | Signs |
|---|---|
| Newborn | Poor suckling, weak cry, refuses breast |
| 1–3 months | Cannot coordinate suck-swallow-breathe pattern |
| Ongoing | Gagging, poor weight gain, frequent choking |
👩🏿⚕️ Why It Happens:
Bilirubin affects brainstem areas responsible for feeding reflexes.
📍Care Tip: Encourage mothers to breastfeed frequently if baby is stable, and refer for feeding therapy if poor suck persists beyond 2 weeks.
🔗 Tool: WHO Infant Feeding Guide – https://www.who.int/publications/i/item/9789240063870
👂 Hearing Loss Due to Severe Jaundice
Red Flags:
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Baby does not startle at loud sounds (by 1–2 months)
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Doesn’t respond to mother’s voice
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Speech delay in toddler years
👂 Why It Happens:
Bilirubin damages the auditory nerve (cranial nerve VIII) — often permanent if not detected early.
🧏♀️ Jaundice is now a leading cause of preventable hearing loss in African infants (Source: WHO Africa Region, 2022)
What To Do:
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Schedule hearing tests for any baby who had severe jaundice or transfusion
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Use OAE or ABR testing at major hospitals or ENT centers
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In rural areas, CHWs should ask caregivers about hearing milestones at each visit
🔗 Hearing Tool: WHO Ear & Hearing Care Manual –
https://www.who.int/publications/i/item/9789240085889
📖 Learning and Developmental Delays
| Age | Possible Concerns |
|---|---|
| 3–6 months | Not smiling, poor head control, not tracking with eyes |
| 6–12 months | Cannot sit, crawl, or respond to name |
| 1–2 years | Doesn’t speak, doesn’t play or imitate, walks late |
| 2–5 years | Trouble understanding or remembering things, poor coordination |
🧠 Why It Happens:
Bilirubin affects deep brain areas like the basal ganglia and cerebellum, critical for movement, memory, and learning.
🔎 Monitoring Tools & Resources
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CHW Jaundice Follow-Up Card (OneWomb version)
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WHO Developmental Milestone Charts:
https://www.who.int/tools/child-growth-standards -
Kenya Early Childhood Intervention Manual (MOH/UNICEF):
https://www.health.go.ke/wp-content/uploads/2022/04/Early-Childhood-Development-Guide.pdf
💬 African Case – Nigeria
A baby boy in Enugu recovered from severe jaundice at 5 days old. At 9 months, the CHW noticed he did not sit or respond to sounds. Referral confirmed hearing loss and delayed motor skills. With early hearing aids and therapy, he started walking at 20 months and began speech classes at 2 years.
✅ Quiz – Effects of Jaundice
Q1. Which part of a baby’s development can be affected by untreated severe jaundice?
A. Hearing
B. Learning
C. Feeding
D. All of the above
✅ Answer: D
Rationale: Jaundice can damage multiple areas of the brain affecting feeding, hearing, and learning.
Q2. A 2-month-old baby who had severe jaundice is not reacting to loud sounds. What should be done?
A. Wait another month
B. Tell the mother to sing louder
C. Refer for a hearing test
D. Use herbs for ears
✅ Answer: C
Rationale: Babies with jaundice history and hearing concerns need early testing.
Q3. What is a red flag for poor feeding in a baby recovering from jaundice?
A. Baby cries after feeds
B. Baby feeds every 2 hours
C. Baby gags, chokes, or stops sucking
D. Baby likes breastfeeding
✅ Answer: C
Rationale: Poor coordination in feeding is a warning sign of neurological impact.
