What is Bilirubin?
Bilirubin is a yellow compound that occurs in the normal catabolic pathway that breaks down
hemoglobin in the blood. It is produced when red blood cells are broken down and is eventually excreted out of the body. In newborns, bilirubin levels can be an important indicator of certain health conditions.
Why is Bilirubin Important in Neonates?
Newborns often have higher levels of bilirubin, leading to a condition known as
neonatal jaundice. This is because their liver is still developing and may not be efficient at processing and removing bilirubin from the bloodstream. Monitoring bilirubin levels is crucial to prevent complications such as
kernicterus, a type of brain damage that can result from very high levels of bilirubin.
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Physiologic jaundice: Normal increase in bilirubin in the first few days after birth.
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Breastfeeding jaundice: Occurs in the first week of life due to insufficient milk intake.
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Breast milk jaundice: Develops after the first week and may persist longer due to substances in breast milk that increase bilirubin reabsorption.
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Hemolytic disease: Conditions like Rh or ABO incompatibility where red blood cells are broken down too quickly.
- Prematurity: Premature infants have underdeveloped livers and may experience delayed bilirubin processing.
How is Bilirubin Measured?
Bilirubin can be measured through blood tests or non-invasive techniques like
transcutaneous bilirubinometry. Blood tests provide a more accurate measure, while non-invasive techniques are often used for initial screenings. It's essential to measure both direct (conjugated) and indirect (unconjugated) bilirubin to understand the underlying cause of jaundice.
- Poor feeding
- Lethargy
- High-pitched crying
- Dark urine
- Pale stools
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Phototherapy: Uses light to convert bilirubin into a form that can be easily excreted.
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Exchange transfusion: Used in severe cases to replace the baby's blood with fresh blood.
- Adequate hydration and feeding: Ensures proper elimination of bilirubin through urine and stool.
Can High Bilirubin Levels be Prevented?
While it may not always be possible to prevent high bilirubin levels, early detection and treatment are crucial. Regular monitoring, especially in infants at high risk, can help manage bilirubin levels effectively. Ensuring the baby is well-fed and hydrated also aids in reducing the risk of severe jaundice.
