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Newborn Jaundice
Newborn jaundice is a common and usually harmless condition in which your new baby's skin and eyes look yellow. About 60% of babies get it.
Jaundice happens when too much bilirubin, a chemical that red blood cells release during their normal breakdown process, builds up in the blood. Sometimes it goes away on its own, or your doctor may suggest light therapy or other treatments to knock it out.
Some of the body's red blood cells break down every day and create bilirubin in the blood. It's the liver's job to filter it out of the bloodstream. When your baby is still in your womb, your liver clears out their bilirubin for them. After birth, your baby's liver takes over.
Sometimes, your newborn's liver can't break down bilirubin as quickly as their body makes it, and it starts to build up. Because bilirubin is a yellow compound, it turns your baby's skin and eyes yellow. It can also happen if the bile ducts are blocked or scarred, a condition called biliary atresia.
Babies have a greater chance of getting jaundice if they're:
Jaundice typically shows up 2 or 3 days after your baby is born and goes away within the first couple of weeks. Some types may show up sooner or much later.
Breastfeeding jaundice happens because your baby isn't eating enough. Your milk may not have come in yet or your baby is having trouble latching on. The more your baby eats, the more quickly their body clears waste, including bilirubin, from their system.
Breast milk jaundice appears after the first week. Doctors don't know exactly why it happens, but they think something in breast milk keeps your baby's liver from processing bilirubin effectively. This kind of jaundice can last for several months.
More serious kinds of jaundice are caused by a disease or condition, such as:
Jaundice may also happen if a mom has a different blood type from their baby. If that's your situation, your body may make antibodies that attack and break down your baby's red blood cells. In some cases, you can help prevent this by getting special shots when you're pregnant.
The telltale sign of jaundice is a yellow color to your baby's skin and yellow in the whites of their eyes. It typically starts on the face. Once bilirubin levels in the blood get higher, the yellow color moves to the chest and stomach, and then, finally, the legs and arms. Jaundice may be harder to notice on dark skin, so check the whites of your baby's eyes and under your baby's tongue to see if those areas look yellowish.
Severe jaundice can be an emergency situation, so call your doctor right away if:
Usually, a doctor can tell your baby has jaundice by looking. But they'll also want to know how much bilirubin is in your baby's blood to help decide on a treatment plan. They may:
If your doctor suspects that a condition is causing your baby's jaundice, they may do other tests, like:
In many cases, jaundice goes away on its own in 1 to 2 weeks. Your doctor will decide whether your baby should wait it out or start treatments like:
Extra feedings. Taking in more breast milk or formula will help your baby poop more often, which can help clear out bilirubin from the body. Or, if your baby is having trouble breastfeeding, your doctor may recommend you feed them breast milk from a bottle or also feed them formula.
Phototherapy. The doctor puts your baby under blue-green lights. It can help bilirubin leave their body in their urine. They'll wear a diaper only so that most of their skin can soak up the light. They'll wear patches to protect their eyes. The light may come from a special pad or mattress that puts out blue-green light.
Intravenous immunoglobulin (IVIg). If your baby's jaundice happens because they have a different blood type from their mom, your doctor may need to give them a blood protein through an IV that helps stop the breakdown of red blood cells.
Exchange transfusion. If your baby has severe jaundice that isn't getting better with other methods, they may need a blood transfusion called an exchange transfusion. In this process, your doctor repeatedly draws small amounts of your baby's blood and replaces it with blood from a donor. Your baby will need to stay in the neonatal intensive care unit (NICU) for the procedure. It's rare for babies to need this level of treatment for jaundice.
Don't hesitate to get your baby checked if you notice signs of jaundice. It's rare, but if severe jaundice is left untreated, bilirubin can enter the brain and cause permanent damage. This condition is called kernicterus, a complication that includes:
There isn't much you can do to prevent the typical jaundice in newborns. But you can help move it along by being sure your baby is well fed. If you're breastfeeding, aim for 8-12 feedings a day in the first days of your baby's life. If you're formula feeding, offer 1-2 ounces every 2-3 hours. Exposing your baby to sunlight also helps break down indirect bilirubin. Sit by the window indoors with your baby or take your baby for a stroll in the stroller if it is a nice day with sunshine.
Determination Of Bilirubin In The Umbilical Blood As An Aid In The Early Diagnosis Of Hæmolytic Disease In The Newborn
The bilirubin content of the blood is increased in hæmolytic conditions, as can be demonstrated by the indirect quantitative reaction of Van den Bergh. It seems probable, therefore, that the presence in the umbilical circulation of increased bilirubin, demonstrated by the indirect reaction, might be interpreted as early diagnostic evidence of hæmolytic disease of the newborn.
Low Bilirubin: What It Means
Bilirubin is a yellowish pigment produced when hemoglobin in your red blood cells breaks down. Once it breaks down, it's sent through your liver, gallbladder, and bile ducts before being excreted.
Your doctor may order a bilirubin test as part of a typical comprehensive metabolic panel or liver panel. A liver panel may include liver function tests and total protein tests. Your doctor might also order a bilirubin test if you have certain symptoms.
Usually, bilirubin levels hover somewhere between 0.3 to 1.2 milligrams per deciliter (mg/dL). Read on to learn more about bilirubin and what levels below this range could mean.
If you're looking at your test results, you'll probably notice a few kinds of bilirubin, including:
Your doctor might say you have low bilirubin levels if any of these are outside of the usual range.
Low bilirubin levels usually don't cause any symptoms and aren't usually a cause for concern. Most people don't even know they have low bilirubin levels until their doctor orders a blood test.
If you have low bilirubin levels and notice any unusual symptoms, make an appointment with your doctor. You may have an unrelated condition that needs treatment.
There aren't any health conditions that cause low bilirubin levels. But consuming certain substances can temporarily lower them.
These include:
Consuming any of these a few hours before a blood test can make your bilirubin levels appear low in your test results.
To avoid this, don't take any of these substances for at least eight hours before a blood test. Your doctor might also give you additional instructions on other things to avoid before the test for accurate results.
There's no clear link between low bilirubin levels and any medical conditions. However, some research suggests that bilirubin acts as an antioxidant. Antioxidants protect tissues throughout your body from damage by substances that can cause cells to break down.
Based on bilirubin's potential antioxidant properties, some believe that not having enough of it can leave certain body parts vulnerable to damage.
This damage could potentially lead to a range of conditions, such as:
Brain lesionsA 2018 study suggests that low bilirubin levels could increase your risk of developing deep white matter lesions in your brain, even if you don't have any other health issues. These lesions are linked to several conditions, including dementia and heart disease.
StrokesLow bilirubin levels may also be associated with blood vessel damage, according to a 2009 study.
This type of damage can increase your risk of having a stroke. The study notes that women are less likely to have a stroke related to low bilirubin levels.
Eye diseaseA 2017 study found that low bilirubin levels may be a marker for diabetic retinopathy. This is an eye condition that happens when blood vessels near the retina at the back of the eye are damaged.
Keep in mind that much more research is needed before experts can draw any concrete links between bilirubin levels and someone's risk of developing these conditions.
While high bilirubin levels can indicate several health issues, low bilirubin levels usually aren't anything to worry about. In some cases, it could be a side effect of a medication you take or having too much coffee before your blood test.
While low bilirubin levels may be associated with certain conditions, this link still isn't totally clear.
If your test results show you have low bilirubin levels, your doctor will likely just keep an eye out for any other symptoms you have and run another test after some time has passed.
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