Soon after her son Jaxson was born, Lauren Clarke noticed that his eyes were yellow and bloodshot. She repeatedly asked if he had jaundice, but was told to continue feeding him and place him in front of a window. It wasn’t until Clarke was readmitted to the hospital six days later with an infection that Jaxson’s jaundice was finally detected by a midwife. His levels had become dangerously high by that point. Jaxson spent an additional five days in the hospital receiving light therapy and antibiotics. Clarke believes that if they hadn’t gone back to the hospital, he could have died or suffered long-term health issues.
The NHS race and health observatory will soon announce funding for research into the effectiveness of jaundice screening in black, Asian, and minority ethnic newborns. This research comes in response to a recent report showing that tests to assess the health of newborns are not effective for non-white children. An interim report is scheduled for May 2024, with final recommendations expected in November 2024.
Jaxson’s aunt, Gemma Poole, who is a midwife, believes that the trauma her family experienced could have been avoided if healthcare professionals knew better ways to identify jaundice in non-white babies. She has created the Essential Baby Company to develop resources and training specifically focused on the needs of women and babies with black and brown skin.
New technologies are also being developed to provide more reliable and racially inclusive methods of identifying jaundice. EarMetrics is one such device that can detect oxygen levels, cardiac function, jaundice, and temperature through its sensitive sensors when inserted into the ear. It is currently being clinically investigated, and early data suggests it provides highly accurate results.
Hospitals are also taking a more proactive approach. Many NHS trusts now routinely measure blood oxygen saturation in all newborns using pulse oximeters. This helps identify serious conditions that may not be apparent through other tests. Jaundice, however, remains more difficult to detect, especially in south Asian babies. National Institute for Health and Care Excellence guidelines state that a test should be given if jaundice is suspected by parents or clinicians.
Sam Oddie, a consultant neonatologist, believes that training in neonatal life support should be more diverse to ensure that clinicians are knowledgeable about how different illnesses present in patients with darker skin.
Clarke hopes that better training and awareness will prevent other families from going through the same trauma that her family experienced. Nottingham University Hospitals is implementing the recommendations from the review of Jaxson’s care, including updating guidelines and policies, increasing staff awareness and understanding, and incorporating new technology such as bilirubinometers.