Hyperbilirubinemia

What is hyperbilirubinemia?

Hyperbilirubinemia, aka infant jaundice, causes newborns to have a yellow discoloration of the skin and eyes. This yellowing is caused by a build-up of excess bilirubin in the blood, tissues, and fluids. Bilirubin is a yellow pigment that is made in the liver during the breakdown of hemoglobin (oxygen transporting protein located on red blood cells). Hyperbilirubinemia is common in infants because their livers aren’t mature enough to effectively remove all the bilirubin from the blood. The condition is especially common in infants that were born prematurely (before 38 weeks). It is also especially common in some babies that are breast fed. 
 
Hyperbilirubinemia usually occurs within the first 5 days of life. It often goes away on its own and doesn’t require treatment. In addition, most cases where treatment is required, the treatment is non-invasive. However, in some cases, the jaundice may be caused by an underlying disease. Complications from infant jaundice are rare, but if the bilirubin level is extremely high and/or the jaundice is not treated properly, brain damage can occur. 
 
 
Risk factors
 
  • Premature birth: Premature babies may not be able to process bilirubin as fast as full term babies. 
  • Significant bruising during birth: Bruising can cause increased breakdown of red blood cells, resulting in increased bilirubin 
  • Breast-feeding: Breast fed babies are at increased risk for jaundice. Especially babies that have difficulty nursing and/or getting enough nutrition. However, due to its benefits, breastfeeding is still recommended. 
  • Blood type: If the mother’s blood type is different than the baby's, the risk for jaundice may be increased. 
 
 
Diagnosis 
Doctors typically detect hyperbilirubinemia based on the appearance of the infant since their skin typically will have a yellow tint to it. The level of bilirubin in in the blood will need to be obtained to determine if treatment is necessary. 
 
Tests to diagnose hyperbilirubinemia include:
 
  • Physical exam
  • Blood samples to look at the level of bilirubin in the blood
  • Transcutaneous bilirubinometer skin test to measure the reflection of a special light shone through the skin. 
  • Additional tests in the case that an underlying disease is suspected. 
 
 
Treatment
In some cases, treatment may not be needed and the jaundice will go away on its own. In cases where the bilirubin level is higher treatment and a longer stay in the hospital nursery may be indicated. 
 
Potential treatments include:
 
  • Phototherapy (light therapy)
  • Exchange transfusion
  • Intravenous Immunoglobulin (IVIg)
  • Fiber optic blanket
  • Breastmilk
  • Treatment of any underlying disease or condition 
 
 
 
 
# HYPERBILIRUBINEMIA BY THE NUMBERS #
  • Approximately 2% of breastfed babies get jaundice
  • Approximately 60% of full term newborns get jaundice 
  • Approximately 80% of premature babies get jaundice 
 
about hyperbilirubinemia
 
 

Sources:
  • "Infant jaundice." Mayo Clinic. Mayo Foundation for Medical Education and Research, 03 Apr. 2014. Web. 28 Sep. 2017.
  • “Hyperbilirubinemia.” MedicineNet, MedicineNet.com, n.d. Web. 28 Sep. 2017. 
  • “Conjugated Hyperbilirubinemia.” WebMD. Medscape, 11 Apr. 2017. Web. 28 Sep. 2017. 
  • “Hyperbilirubinemia in the Newborn.” University of Rochester Medical Center.  University of Rochester Medical Center Health Encyclopedia, n.d. Web 28 Sep. 2017. 
  • “Hyperbilirubinemia in the Term Newborn.” American Academy of Family Physicians. American Family Physician, 15 Feb. 2002. Web. 28 Sep. 2017. 
  • “Jaundice in Newborns (Hyperbilirubinemia)- Topic Overview.” WebMD, n.d. Web. 28 Sep. 2017. 

 

From Our Blog: Premature Labor/Birth Risk Factors

Infants born premature have increased rates of health problems and lifelong disabilities.The underlying causes of premature birth are not well understood, but genetic, social, and environmental factors likely all play a role. Lifestyle factors such as stress and smoking can also elevate risk. Check out this infographic to learn more about some of the biggest risk factors for premature labor and birth:

premature labor/birth risk factors


 

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