🌍 Real-Life Case Vignette – Baby Chinedu from Enugu, Nigeria
👩🏽🍼 Background:
Chinedu was born at home in a rural village in Enugu State, Nigeria. His mother, Ada, was 22 years old and delivered him with the help of a Traditional Birth Attendant (TBA). He was born full term and cried at birth.
By Day 2, Ada noticed her baby’s eyes looked “slightly golden.” Her aunt said,
“It’s just breastmilk jaundice. Stop breastfeeding for one day and give palm kernel water.”
⏳ Delay in Action:
Instead of going to a clinic, Ada followed the advice. She stopped breastfeeding and gave herbs. By Day 4, Chinedu had become:
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Sleepy and hard to wake
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Was not feeding well
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Had yellow skin down to his legs
Ada’s husband borrowed money to take them to a primary health center, but they were referred to the teaching hospital in Nsukka, a 2-hour journey.
🏥 Hospital Outcome:
At the hospital:
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Chinedu’s bilirubin level was dangerously high (>20 mg/dL)
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He was started on phototherapy
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A blood transfusion was done due to hemolytic jaundice likely caused by G6PD deficiency
The doctors explained that had they arrived even one day later, the baby might have suffered kernicterus (brain damage).
Chinedu survived—but needed follow-up for possible hearing loss and developmental delay.
🧠 Lessons from the Case:
| Issue | Lesson |
|---|---|
| Home delivery with no postnatal checkup | Risk of missing early jaundice signs |
| Use of herbs and stopping breastfeeding | Delayed care and worsened jaundice |
| Lack of transport funds | Increased time to reach proper facility |
| No early bilirubin screening | Missed chance for preventive action |
💬 “If I had known, I would never have stopped breastfeeding. I tell every pregnant girl in our village to check their baby’s eyes and run to the health center if it turns yellow.”
— Ada, Chinedu’s mother
📎 Resources Related to This Vignette
-
Case report on delayed jaundice care in Nigerian newborns
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957776/ -
Study: G6PD and severe jaundice in Nigeria
https://pubmed.ncbi.nlm.nih.gov/33277230/ -
Nigeria Neonatal Guidelines – Federal Ministry of Health
https://www.health.gov.ng/doc/NeonatalGuidelines.pdf -
WHO: Managing Newborn Illness in Low-Resource Settings
https://apps.who.int/iris/handle/10665/42633
🧩 Comprehension Quiz – Case Vignette
Q1. What was the first sign of jaundice in Baby Chinedu?
A. Rash on the body
B. Crying nonstop
C. Yellow eyes
D. Cold hands
✅ Answer: C
Rationale: The baby’s eyes turned yellow on Day 2—an early sign of jaundice.
Q2. What mistake did the family make after noticing the yellowing?
A. They went to the hospital too quickly
B. They gave palm kernel water and stopped breastfeeding
C. They vaccinated the baby early
D. They used too much phototherapy
✅ Answer: B
Rationale: The family followed a cultural myth, which delayed proper care.
Q3. What life-saving treatment did Chinedu receive at the hospital?
A. Oxygen therapy
B. IV antibiotics
C. Blood transfusion and phototherapy
D. Herbal detox
✅ Answer: C
Rationale: He needed urgent phototherapy and a blood transfusion due to high bilirubin levels.
