Bilirubin is produced during the process of red blood cell breakdown. This is a normal process that allows the body to get rid of old and damaged red blood cells. In order to remove bilirubin from the body, it must be broken down by the liver. Once this is done, bilirubin can be excreted in the stool. When an infant is born, its liver must start taking over this job from the placenta. While the liver is still adapting to this new function, some bilirubin build up often occurs, causing the infant to look yellow. For most babies little to no complications occur from this temporary build up; but if bilirubin is allowed to get too high, several complications can occur, including brain damage. Your physician should monitor your baby's bilirubin to determine if treatment is needed.
Jaundice
Jaundice is the term used to refer to the yellow tinged skin and eye sclera in individuals because of high bilirubin levels. It is often the first sign your baby has high bilirubin levels. It can affect both full-term and premature babies. Causes of jaundice include an immature liver and insufficient feeding. Despite the coloration being distressing to parents, most jaundice is harmless and disappears within the first weeks of life. However, any jaundiced baby should be monitored by a physician to ensure the cause is harmless.
Brain Damage
When the bilirubin level reaches extremely high concentrations, it can cause a form of brain damage known as kernicterus. Rare, but very serious complications resulting from bilirubin deposition in the brain can include cerebral palsy and deafness. These conditions are irreversible. These results are rare because treatment is usually initiated before bilirubin reach high enough levels to harm the brain.
Red Blood Cell Damage
High bilirubin levels sometimes signal that your baby has a red blood cell disorder. This can happen when your baby simply has excess red blood cells to break down, known as polycythemia, or if increased red blood cell breakdown occurs. If high bilirubin levels are accompanied by red blood cell breakdown, it is a cause for concern as it means an underlying problem exists causing bilirubin to remain elevated and your baby may not have sufficient red blood cell stores. Treatment is usually needed in these cases to avoid brain toxicity and replenish red blood cells.
Treatment
Treatment for jaundice revolves around breaking down bilirubin so that it can be excreted. This is most commonly done by using phototherapy. In phototherapy, light is used to break down bilirubin into a form the baby can excrete. Babies who have elevated bilirubin because of difficulty feeding are usually sent to a lactation consultant to ensure they are getting fed often enough and that no dangerous substance in the mother's breast milk is causing jaundice.
References
- FamilyDoctor.org: Jaundice and Your Baby
- University of Michigan Health Center; Your Baby, Jaundice and Phototherapy; May 2005
- American Pregnancy Asociation; Breastfeeding and Jaundice; March 2009
- Emory University School of Medicine; Neonatal Jaundice; Amy Pattishall
- "American Family Physician"; Hyperbilirubinemia in the Term Newborn; Meredith Porter, et al.; February 2002
- MedLinePlus; Newborn Jaundice; Neil Kaneshiro, et al; November 2010
