If you’ve recently had a baby, then you probably remember questions about your child’s bilirubin levels and concern about jaundice. Here are the facts:
What is Jaundice?
The medical term “jaundice” refers to the yellow skin color that your baby may experience. “Bilirubin” is the chemical in the blood that makes the skin look jaundice, or yellow.
How do I test for Jaundice?
You can test for jaundice in one of two ways: through the skin or blood. Testing through the skin is called “transcutaneous.” Testing through the blood is called a serum test. The blood test is considered the most accurate. A blood test is usually obtained by performing a heel stick.
Why does jaundice happen?
Bilirubin comes from the breakdown of blood. It is metabolized (or gotten rid of) through the liver. When a woman is pregnant, her liver takes care of the bilirubin for herself and the baby. After birth, it takes a few days for the baby’s liver to become effective at removing the bilirubin.
What things make jaundice worse?
Anything that causes the blood to break down can make bilirubin worse (e.g., a difference in blood type between mom and baby, a traumatic birth with a lot of bruising). Also, a baby needs to eat frequently to help metabolize the bilirubin. So if nursing or feeding isn’t going well, a problem can arise. Sometimes a baby has an elevated bilirubin for no apparent reason at all.
Why does a high bilirubin level matter?
If a baby’s bilirubin gets too high, the bilirubin can cross into the brain and cause brain damage. The medical term is kernicterus. What do the bilirubin numbers mean and what is a normal bilirubin value? There is no specific normal value in a newborn. Eventually (when all is resolved), the total bilirubin will be less than 1. Bilirubins tend to rise and peak between the 3rd and 5th day of life. In general, we tend to get worried when the bilirubin numbers get into the high teens. So, a number of 10 on the first day is very worrisome (by the time it peaks, the number will be way too high), while a value of 10 on the 5th day is not something to worry about.
Should my baby’s bilirubin be tested?
This is up to your pediatrician. In all of the hospitals where I round (work) and see babies, it is routine to do bilirubin checks on all babies on the second or third day of life (so in a vaginal delivery, the day you go home). Your baby should be tested sooner if your baby looks jaundice.
How do I fix a high bilirubin?
There are two ways to decrease a bilirubin. The first is frequent, good feeding. The second is something called phototherapy (like a tanning bed for infants). Your pediatrician will let you know if your baby needs phototherapy (either in the hospital or at home).
What special situations require bilirubin testing?
If your baby is premature, then we worry about lower levels of bilirubin. If your child is older (not in the first couple weeks of life) and has an elevated bilirubin, then this can be a sign of a major medical problem that needs further follow up with your pediatrician.
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