Jaundice / Hyperbilirubinemia

All babies are jaundice (yellow), but only a minority will require treatment and close monitoring. In rare cases, extreme jaundice can cause brain damage. Doctors order bilirubin tests as a measure of a newborn’s jaundice level. There are transcutaneous (through the skin) bilirubin meters, but the most accurate measurements of bilirubin done are through blood testing.

Bilirubin is normally present in red blood cells (RBCs). Anything that breaks up RBCs will increase the bilirubin level. It therefore follows, that newborns with different blood types than their mother or with significant bruising are at increase risk for jaundice. Bilirubin molecules are normally cleaned up by the liver and then pooped out in the stool. Bilirubin makes stools darker.

Bilirubin levels naturally peak on day 3 or 4 of life. It is not a coincident that this peak occurs at the same time most newborns are at their lowest weight. Once a child is feeding and stooling well these level typically decrease.

If your child is “too jaundiced” your doctor may initiate phototherapy. Phototherapy typically consists of lights above your baby. The infant pictured on the right is laying on a bili-blanket. These lights help reduce the bilirubin level.

This newborn is laying on another type of bili-blanket.

Written April 2010 by
Dr. Gordon, Windermere Pediatrician