![]() ![]() If your baby's bilirubin level is too high we recommend phototherapy which involves your baby lying under fluorescent lights. Which babies are most at risk of high jaundice levels?īabies whose blood group is different from that of their mother.īlood taken from a heel prick is tested to check your baby's bilirubin level. If the level is too high the baby will need further tests until the bilirubin level is going down and nearly to normal.Īdditional blood tests may be carried out to find the cause of any jaundice that lasts for more than three weeks. By testing and monitoring your baby's bilirubin level we can provide treatment quickly if the level is too high, to prevent any harm to the baby. Is a high jaundice level serious?Ī very high bilirubin level may be harmful if left untreated.Ĭomplications of a very high level of bilirubin include hearing problems and brain damage. Premature babies (less than 37 weeks gestation) require treatment for jaundice at lower levels than term babies. If your baby has a higher level than this, treatment will be recommended to help reduce the level. The acceptable maximum jaundice, or serum bilirubin level (measured by the SBR blood test) for a newborn baby is less than about 370 (although this does depend on how old your baby is). It is common for babies to become jaundiced soon after birth, but some babies develop a high level of jaundice that requires treatment. ![]() As well as having a yellow colour the baby may be very sleepy and need to be woken for feeds. Jaundice usually appears on the second or third day after birth. This extra bilirubin is stored in the skin giving the baby a yellow or tanned look. Some babies find it difficult to cope with the amount of bilirubin during the disposal of these extra blood cells, so their level of bilirubin may build up. These are broken down by the baby's liver. Once born, the baby needs to get rid of these extra blood cells. The yellow colour is caused by bilirubin, a by-product of the normal breakdown of extra red blood cells no longer needed by the baby following birth.Īn unborn baby requires extra oxygen when in the uterus so extra blood cells are needed to carry the oxygen around the baby's body. As the liver conjugating system also requires oxygen and glucose to function efficiently, hypoxia and hypoglycaemia may also slow down this process and increase the risk of hyperbilirubinaemia ( Blackburn, 2017 Rankin, 2017).Jaundice is the name for the yellow colour that your baby has. Mutations in this enzyme that reduce its function can result in Gilbert and Crigler-Najjar syndromes, which are characterised by hyperbilirubinaemia due to reduced functioning of the liver's bilirubin-conjugating ability and the resulting build-up of unconjugated bilirubin ( Wong and Stevenson, 2015 Chang et al, 2017). In the liver it undergoes conjugation (it is combined with glucuronic acid by the enzyme glucuronyl transferase) to produce conjugated bilirubin, which is more water-soluble and can thus be excreted in urine and bile ( Mitra and Rennie, 2017 Rankin, 2017). ![]() This is lipid-rather than water-soluble, so is transported to the liver for metabolism bound to albumin ( Blackburn, 2017). This occurs in phagocytic monocytes and macrophages in various tissues of the body ( Mitra and Rennie, 2017), and first results in a form of bilirubin called unconjugated bilirubin. Most bilirubin is produced during the breakdown of senescent red blood cells, with bilirubin being produced as a result of the breakdown of the haem component of haemoglobin ( Figure 1). This normal imbalance that produces physiological jaundice can, however, be exacerbated by factors that result in pathological jaundice, which can result in neurological damage, dysfunction, and death ( Ng and How, 2015). ![]() Bilirubin is produced during the breakdown of red blood cells, and in newborn infants there is a transitional imbalance between its production and elimination, resulting in an excess of bilirubin. It is the result of rising levels of bilirubin, which eventually binds to tissues such as the skin and sclera, producing clinically recognisable jaundice around day 3 or 4 ( Mitra and Rennie, 2017 Rankin, 2017). Physiological jaundice is common in the first week of life, occurring in around 60% of term and 80% of preterm infants ( Ng and How, 2015 Mitra and Rennie, 2017). ![]()
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