About High Bilirubin Levels in Newborns
Neonatal jaundice is caused by various causes and risk factors, including:
- Genetic factors: Some genes can impact how well liver enzymes process bilirubin. For instance, changes (mutations) in the UGT1A1 gene can reduce the enzyme’s ability to link bilirubin to other substances, which is needed to remove it from the body. When this enzyme doesn’t work as well, it can lead to higher levels of bilirubin that haven’t been processed yet.
- Perinatal factors: Certain birth-related issues can increase the risk of newborn jaundice. For example, injuries during delivery, like head trauma, can lead to more red blood cells breaking down, which then releases more bilirubin.
- Maternal factors: Some mother-related factors increase the risk of jaundice and cannot be changed to lower the chances of infants getting jaundice. For example:
- Maternal age over 25 years old slightly raises the risk.
- Mother and baby having incompatible blood types can increase the chance of the baby’s bilirubin levels to rise.
- Neonatal factors: Certain characteristics in a newborn can raise the chances of developing jaundice. These include:
- Being male: Male babies have a slightly higher risk of jaundice, although the exact reason isn’t fully understood.
- High count of immature red blood cells: When there are more immature red blood cells, more bilirubin is produced as they break down, increasing the chance of jaundice.
- Treatment with intravenous immune globulin (IVIG): IVIG is sometimes used for babies with certain blood issues. It can raise bilirubin levels, leading to a higher risk of jaundice.
It's important to note that these risk factors may be different in different newborns. It is always recommended to consult with a healthcare professional for personalized advice and management.
The early symptoms of neonatal jaundice may include:
- Yellowing of the skin and eyes (jaundice)
- Pale stools
- Dark urine
As the condition progresses or becomes more severe, additional symptoms may occur, such as:
- Extreme sleepiness or lethargy
- Poor feeding or difficulty breastfeeding
- High-pitched crying
- Arching of the back
- Muscle stiffness or limpness
- Difficulty waking up or staying awake
- Irritability or fussiness
Most cases of neonatal jaundice are mild and clear up on their own. However, in severe cases, jaundice can cause brain and nerve damage and other health issues. That’s why it’s essential to watch your baby’s symptoms closely and contact a doctor if you see any worrisome changes or if the jaundice seems to be getting worse. A healthcare provider can offer the right treatment and advice for your baby’s condition.
To diagnose neonatal jaundice, the following examinations, tests, and procedures are commonly performed:
- Physical exam: The healthcare provider will examine the baby’s skin and eyes for yellowing, which can be a sign of high bilirubin levels.
- Lab tests: Blood tests may be ordered to check the levels of bilirubin in the blood.
To determine how advanced or severe neonatal jaundice is, additional exams, tests, and procedures may include:
- Genetic testing: In certain cases, genetic tests can check for any gene changes that might be causing high bilirubin levels.
- Imaging studies: X-rays or MRIs may be used to rule out other conditions that could contribute to jaundice, like liver or bile duct issues.
- Clinical procedures: Hearing tests or other specific exams can be done if jaundice becomes severe, as it can sometimes affect areas like hearing.
- Continuous monitoring: Regular blood tests may be used to track bilirubin levels over time, helping assess if jaundice is improving or if treatment is needed.
It's important to consult with your healthcare provider to determine which specific examinations, tests, and procedures are appropriate for your individual situation.
The goals of treatment for neonatal jaundice are to:
- Reduce bilirubin levels in the blood to prevent brain damage and a serious condition called kernicterus, which can happen if bilirubin builds up too much
- Prevent the harmful effects of excess bilirubin on a newborn’s brain and nerves
The following treatments are recommended to achieve these goals:
- Phototherapy: This is the main treatment for neonatal jaundice. It involves exposing the baby's skin to special lights that help break down bilirubin into a non-toxic form, which can then be eliminated from the body through urine and stool.
- Blood exchange transfusion: In severe cases, when phototherapy is not effective enough, a blood transfusion may be performed. This procedure involves removing a small amount of the baby's blood and replacing it with donor blood, which helps lower the bilirubin levels.
- Medication: In some cases, medication may be prescribed to help reduce bilirubin levels. These medications help lower bilirubin levels either by increasing its removal through urine or by slowing down how much of it is made.
- Health behavior changes: Parents should make sure their baby is well-fed and getting enough nutrients, as this helps remove bilirubin from the body. Breastfeeding is encouraged because it promotes regular bowel movements, which helps clear bilirubin.
- Monitoring and follow-up: Regular monitoring of bilirubin levels is essential to ensure that treatment is effective and that bilirubin levels are decreasing as expected. Follow-up visits with healthcare professionals are necessary to assess the baby's progress and make any necessary adjustments to the treatment plan.
It's important to note that specific medication types and dosages should be determined by a healthcare professional based on the individual baby's condition and needs. Additionally, each treatment option carries potential risks and side effects, so it's important to discuss these with your healthcare professional as well.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.