The reason for increased oral feeds for newborn in Physiological jaundice?

KPSC Staff Nurse - 2017

Child Health Nursing (Pediatrics)

Medium

Appeared in: KPSC Staff Nurse - 2017

Explanation

Frequent feeding stimulates the gastrointestinal tract, increasing peristalsis and the frequency of bowel movements.
Bilirubin is processed by the liver and excreted into the intestines through bile.
The primary route for eliminating bilirubin from the body is through stool (feces).
By increasing the frequency of stools, feeding directly enhances the excretion of bilirubin, preventing its reabsorption from the gut (enterohepatic circulation).

Option B: Feeding does not cause the body to produce more bilirubin. Bilirubin is a byproduct of the normal breakdown of red blood cells.
Option C: The goal of frequent feeding is to decrease, not enhance, the absorption of bilirubin from the intestine back into the bloodstream (a process called enterohepatic circulation).
Option D: The term 'bilirubin exchange' is not a standard physiological process stimulated by feeding. It may be confused with 'exchange transfusion,' which is a medical procedure for severe hyperbilirubinemia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of physiological jaundice in newborns as background academic context rather than a clinical decision trigger.
A primary nursing responsibility is to educate and support mothers in establishing frequent and effective breastfeeding (8-12 times in 24 hours) to prevent and manage physiological jaundice.
Nurses must monitor for signs of adequate intake, including the number of wet and soiled diapers, and assess the infant for worsening jaundice, lethargy, or poor feeding.
What if? If the newborn is too sleepy to feed effectively, the nurse should instruct the parent to unwrap and stimulate the baby. If poor feeding persists, the healthcare provider must be notified, as supplementation or phototherapy may be necessary to prevent dangerously high bilirubin levels.

How to Approach the Question

First, identify the core subject: physiological jaundice in a newborn. The question asks for the 'reason' behind a specific intervention (increased feeds).
Recall the basic pathophysiology of bilirubin. It's a waste product from red blood cell breakdown that needs to be removed from the body.
Consider the body's main excretion routes: urine and stool. How does feeding relate to these?
Recognize that feeding stimulates digestion and gut movement, which leads to more stool.
Connect these facts: More feeding → more stool → more removal of waste products. Therefore, feeding enhances the excretion of bilirubin.
Evaluate the options based on this logic. 'Excretion' is the direct outcome. 'Production,' 'absorption,' and 'exchange' are physiologically incorrect in this context.

Concept Tested & Keywords

QPCpDddCjaYv2tM3kOTPIQ

E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 168-170, 172-174

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 1 (pp 36-238 of 713) p. 194-196