Hyperbilirubinemia AKA Jaundice

What is it?
Hyperbilirubinemia is an abnormally high level of bilirubin in the blood. You may have heard of it as Jaundice, causing yellowing of the skin. About 50-60% of full term and 80% of pre-term newborns are visibly yellow during the first 3 days of life. It is most common among Asian, Native Americans and Eskimo infants. It is considered not to be a harmful condition, if treated. Without treatment, bilirubin levels can become too high and this may affect babys brain and cause seizures, mental retardation, behavior disorders and or hearing loss.

What causes it?

There are various causes, but basically, either bab ys body is creating too much bilirubin or not getting rid of it fast enough. Bilirubin is a product of destroyed red blood cells, kind of like trash and usually, the liver helps to pick up this trash and get rid of it thru the intestines, helping baby to poop it out. This process becomes altered in some babies, either too much red blood cells are being destroyed due to a blood abnormality or there is a delay with the liver and intestines trying to rid the body of it. So, the bilirubin remains in the blood and starts to become visible as yellowing of the skin, eyes and mouth.

What is it?
What causes it? What signs and symptoms should I
Resources:
Lowdermilk, D. L., Perry, S. E., & Cashion, K. (2010).Maternity nursing. (8th ed. ed.). Maryland Heights, MO: Mosby.

look for in my baby? What are the treatment options? Is it preventable?

Mayo Clinic Staff. (n.d.). Retrieved from http://www.mayoclinic.com/he alth/infant-jaundice/DS00107

Created by: Brandi KCC ADN-SN

What are the treatment options?

After determining, what level of bilirubin is in babys blood, either low, intermediate or high, treatment options will be determined by babys pediatrician. Testing for these levels will be done by a blood test or an instrument that looks much like a thermometer, called a BiliChek, that checks bilirubin levels on top of the skin. Treatment options available are: Light Therapy aka Phototherapy: This special lighting changes bilirubin so that baby can poop and pee it out. Baby will only have a diaper and eye shield on during treatment. IV Immunoglobulin: if this is a result of an incompatibility between mom and babys blood Severe Cases: Blood Transfusion: Babys blood is taken out in small amounts and replaced by new blood, this is performed at the hospital under very close supervision

What signs and symptoms should I look for in my baby?

You should be on the lookout for the following, especially since signs and symptoms may not be visible until after a few days after the birth of your baby.

Is it preventable?
Depends on the cause, but usually no. The only cause that may be prevented would be lack of nutrition, due to feeding difficulties. Feeding should normally take place every 1-3 hours. The progression from hyperbilirubinemia to brain damage is preventable, with treatments previously discussed. Be sure to follow up with your caregiver after discharge, especially within the first 48-72 hours after discharge. Also, be aware and continue to watch baby for signs and symptoms of progressing hyperbilirubinemia. Factors that may put your baby at risk are the following: Born at less than 38 weeks Breastfeeding, due to lack of sufficient intake Previous sibling with hyperbilirubinemia

Visible yellowing of the skin, usually begins at babys head and moves downward. To check for this, be sure to be in good natural lighting. With one finger, press on babys skin and if after removing your finger, babys skin appears yellow, notify your primary care provider. Yellowing of the eyes and inside the mouth Baby becomes very tired and very difficult to wake up Babys eating pattern has noticeably decreased. Lack of nutrition can keep bilirubin from leaving the body thru babys poop.