Hyperbilirubinemia - Symptoms & Treatment

Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood. The heme portion of the hemoglobin molecule is converted into a yellow pigment called bilirubin, which is carried in the blood to the liver where it is chemically modified and then excreted in the bile into the newborn's digestive tract. Babies are not easily able to get rid of the bilirubin and it can build up in the blood and other tissues and fluids of the baby's body. Because bilirubin has a pigment or coloring, it causes a yellowing of the baby's skin and tissues. In most newborns, the level of bilirubin in the blood increases in the first days after birth, causing the newborn's skin and the whites of the eyes to appear yellow (jaundice). Also, breastfed newborns tend to have somewhat higher blood levels of bilirubin during the first week or two. It may also be caused by hemolysis (rapid breakdown of red blood cells), as occurs with Rh incompatibility or ABO incompatibility. In almost all cases, moderately elevated blood levels of bilirubin due to breastfeeding are not of concern. However, newborns who are slightly premature and are breastfeeding, especially if discharged early from the hospital, must be monitored closely for hyperbilirubinemia because they can develop kernicterus if the bilirubin level becomes very high.

Causes of Hyperbilirubinemia

The common Causes of Hyperbilirubinemia :

• Occurs as a "normal" response to the baby's limited ability to excrete bilirubin in the first days of life.
• Inadequate liver function due to infection or other factors
• A condition that results from the breakdown of red blood cells due to hemolytic disease of the newborn (Rh disease), polycythemia, or hemorrhage
• About 2 percent of breastfed babies develop jaundice after the first week.
• Occurs in some baby's in the first week due to low intake or dehydration.

Symptoms of Hyperbilirubinemia

Some Symptoms of Hyperbilirubinemia :

• Fatigue and weakness
• Jaundice of the skin
• Darkening of the urine
• Loss of appetite
• Abdominal pain
• Jaundice (yellowing) of the whites of the eyes

Treatment of Hyperbilirubinemia

• Another form of phototherapy is a fiberoptic blanket placed under the baby. This may be used alone or in combination with regular phototherapy.
• Treatment of breast milk jaundice often requires stopping the breastfeeding for one to two days and giving the baby formula often helps lower the bilirubin levels. Breastfeeding can then be resumed.
• When this is not the case or when multiple causes are possible, consultation with a gastroenterologist or hepatologist may be helpful.