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High and normal bilirubin levels in newborn infants explained

jaundiced baby high bilirubin 2 3 4 5 6 7 8 9 days birthMany question around jaundice babies and the form is as ” My 9/3/4 day old baby girl/boy is jaundice/ a bili baby/”pumpkin” colored for about 2 weeks?”
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I will try to highlight the main points and rearrange most frequently asked questions and the recommended tasks to rescue your baby fast.

In newborn babies, though, jaundice is common because their liver is often slower to process bilirubin and because they have extra red blood cells that begin to break down soon after they are born. In otherwise healthy newborns, jaundice usually peaks at about three to five days of life and then begins to go away on its own. In breastfed babies, this is called “breastfeeding jaundice” and can take as long as two to three weeks. Jaundice during the first 24 hours of life is not considered normal and will prompt your pediatrician to do some tests on your baby to look for the cause.

General Causes of hyperbilirubinemia in children include:
* newborn jaundice (physiologic jaundice)
* breastfeeding jaundice
* breast milk jaundice
* viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E)
* hemolytic anemia
* disorders present since birth that cause problems processing bilirubin (Gilbert’s syndrome, Dubin-Johnson syndrome, Rotor’s syndrome, or Crigler-Najjar syndromes)
* biliary atresia
* autoimmune hepatitis
* malaria Jaundice not transferred from pregnant women to her child after birth if the pregnant cured before gestation because Billirubin is a liver function substance and not participate in reproduction functions but if the women still jaundice then she get pregnant then a probability of jaundice transfusion through blood may be present.

Best baby’s hyperbilirubinemia cure and treatment:
incubation : had to be on a bili blanket for about 2 weeks, wrapped her in this blanket and I put her under the light and within 24 hours she no longer had jaundice

biliblanket. (A blanket with artificial lights sewn into it.): The infant is placed naked under artificial light in a protected isolated to maintain constant temperature. The eyes are protected from the light. The American Academy of Pediatrics recommends that breastfeeding be continued through phototherapy, if possible.

Phototherapy: a process in which infants are exposed to fluorescent-type lights which break down excess bilirubin so it can be excreted through the baby’s liver. The baby usually lies naked under the lights for a day or two, with her eyes covered by a protective mask.

After billirubin is damaged by light it is voided through urine and bowels.

If your baby’s level of bilirubin doesn’t require phototherapy, you can still help bring it down by giving her a little exposure to sunlight in the early morning or late afternoon, taking care to avoid direct exposure to sunlight especially during the day. strip her to her diaper and let her soak up the indirect sunlight, “this is not usually possible”. The baby would need to be completely undressed and would be at risk of sunburn.

In case of jaundiced babies The most followed procedures are:
Just keep nursing the baby 10-12 times in a 24 hour period. You do not need to give formula to clear it up. Just keep him/her under a special light. After a week
Breastfeeding helps a lot.
Don’t listen 2 people who tell you to give him water cause the extra billirubin comes out of the feces not the urine.
In the most severe cases of jaundice, an exchange transfusion is required. In this procedure, the baby’s blood is replaced with fresh blood. Treating severely jaundiced babies with intravenous immunoglobulin may also be very effective at reducing bilirubin levels.

The harmful may be occurred to the baby by bilirubin differs by the bilirubin level in the blood over the next days of birth until 4 to 8 weeks
Bilirubin level in the day 1 of birth until day four start down from 6 – 8 mg/dl and peaks within next three days and may be peaked or over peaked to 13 – 18 mg/dl in the day four of birth, it should be down from the fifth day until the day 15 of birth at most.
Bilirubin level exceeding 18 mg/dl after 4 days it should be treated fast with incubation.
Bilirubin level shouldn’t be more than 20 mg/dl after week, if it is arrived the baby must hospitalized immediately until it be down.
Some babies may have higher bilirbin levels after it being decrease, this is due to breastfeeding and will be treated by biliblanket for a few days until bilirubin be ok again, this happen within 2 – 4 weeks.
In the bilirubin level higher than 23 mg/dl, High bilirubin can cause brain damage, although rarely, affect the brain in a condition called kernicterus.

It must be monitored closely until he is out of a dangerous level.

Types of bilirubin in newborn babies:
Physiological jaundice usually appears between day 2 and 3, peaks between days 2 and 4, and clears by 2 weeks. Physiological jaundice usually causes no problems.
Breast milk jaundice is non-harmful form of newborn jaundice. Breast milk may contain a substance that increases reuse of bilirubin in the intestines. Such jaundice appears in some healthy, breastfed babies after day 7 of life, and usually peaks during weeks 2 and 3. It may last at low levels for a month or more.
Breastfeeding jaundice is a type of exaggerated physiological jaundice seen in breastfed babies in the first week, especially in those that are not nursing often enough. It is different than breast milk jaundice in that it occurs later and is caused by the milk itself.
Pathological bilirubin: is due to a disease in liver or other cause.
Example 1: Billirubin level peaks from day 1 until day 4 days old

· daughter was born @ 36 weeks gestation, due to my developing preeclampsia
· billirubin level was 8.8 after two days of birth
· billirubin level was at 13.6 in the day fourth of birth
· as jaundice babies are often sleepy

Recommendations:
· just put her in the sun when it shines on the carpet, or the bed. That will clear her right up.
· breastfeed : pump and feed her extra with a syringe or dropper

Example 2: high bilirubin with mild arthritis.
Total bilirubin was 18 mg/dl (normal bilirubin level is up to 1.0 mg/dl)
Total bilirubin after 2 days is down to 13 mg/dl
Serum CRP is 48 (negative CRP is less than 12 mg/dl)
CBC show high erythrocytes count and normal in other indices.
Is these results too danger for newborn or just fine?

The answer is:
This baby is fine and bilirubin level will be ok and continue down in the the next few days
No need of light incubation or treatments, it may be a dew minutes on lights to help decrease jaundice status faster.

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