Bradley Hodshire

Carrie Baker-Chizmar

27 March 2017

OB

Hyperbilirubinemia

Hyperbilirubinemia is a condition in which there is an excess of bilirubin in the

blood. The bilirubin is released from the liver due to the breakdown of red blood cells

(RBC). The bilirubin can build up in the blood, tissues, and other fluids, giving the skin and

sclera’s a yellow tint also known as jaundice and can make the babies fussy eaters. Babies

are likely to get this if they have an immature liver (Physiologic jaundice, which is after the

first 24 hours of life) or it could be caused by a lack of sufficient intake from breastmilk

(breastmilk jaundice). Pathogenic jaundice is a normal response to the baby’s inability to

get rid of the bilirubin in the first 24 hours of life.

There are a lot of factors that can increase the risk of this condition. A few of those

risks include short red blood cell life, preterm/late term babies, immature liver, trauma

from birth causing bruising, delayed feeding will cause the intestines to reabsorb the

bilirubin, and lack of intestinal flora because the bacteria breaks down bilirubin to a non-

absorbable element which is then expelled via defecation. Jaundice can be seen with 60%
of newborns and 80% of preterm babies especially if the mother has diabetes or mothers

with Rh disease.

Hyperbilirubinemia is diagnosed with RBC tests, bilirubin levels, and a Coomb’s

test. There are a few different treatments and the doctor will choose which treatments to

do based on their age, health, medical history, progression of condition, outlooks for

condition, the baby’s tolerance to the medications/treatments/therapies, and of course the

mother’s opinion.

The doctors have a few different options to choose from in their successful road to

treatment. The most common would be phototherapy, because bilirubin absorbs light the

excess bilirubin and jaundice will decrease when a unique blue spectrum light is placed

above the baby. The light stays shinning on them throughout the day and night and make

take several hours to notice any improvement. During phototherapy, the baby’s eyes have

to be protected and their temperature monitored. To determine if phototherapy is working,

blood levels of bilirubin need to be checked. A transfusion is always and option too. This

includes both giving and receiving small amounts of blood via a vein or artery to increase

RBC count and lower the bilirubin levels. If possible continue breastfeeding the babies that

are getting the phototherapy due to the increased risk of becoming dehydrated and weight

loss.

In conclusion, hyperbilirubinemia could happen but there are so many measures to

ensure the baby’s safety. Luckily it is an easy diagnosis and can start necessary treatments

to fix the problem as soon as it is noticed. Nurses and tech’s are trained to deal with this

and all the equipment is on hand ready to use if needed.

Work cited:

"Default - Stanford Children's Health." Stanford Children's Health - Lucile

Packard Children's Hospital Stanford. Stanford Medicine, 2017. Web. 27 March. 2017.