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Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood. When red blood cells break down, a substance called bilirubin is formed. 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. This is called hyperbilirubinemia. Because bilirubin has a pigment or coloring, it causes a yellowing of the baby's skin and tissues. This is called jaundice.
Depending on the cause of the hyperbilirubinemia, jaundice may appear at birth or at any time afterward.
During pregnancy, the placenta excretes bilirubin. When the baby is born, the baby's liver must take over this function. There are several causes of hyperbilirubinemia and jaundice, including the following:
About 60 percent of term newborns and 80 percent of premature babies develop jaundice. Infants of diabetic mothers and of mothers with Rh disease are more likely to develop hyperbilirubinemia and jaundice.
Although low levels of bilirubin are not usually a concern, large amounts can circulate to tissues in the brain and may cause seizures and brain damage. This is a condition called kernicterus.
The following are the most common symptoms of hyperbilirubinemia. However, each baby may experience symptoms differently. Symptoms may include:
The symptoms of hyperbilirubinemia may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
The timing of the appearance of jaundice helps with the diagnosis. Jaundice appearing in the first 24 hours is quite serious and usually requires immediate treatment. When jaundice appears on the second or third day, it is usually "physiologic." However, it can be a more serious type of jaundice. When jaundice appears on the third day to the first week, it may be due to an infection. Later appearance of jaundice, in the second week, is often related to breast milk feedings, but may have other causes.
Diagnostic procedures for hyperbilirubinemia may include:
Specific treatment for hyperbilirubinemia will be determined by your baby's physician based on:
Treatment depends on many factors, including the cause of the hyperbilirubinemia and the level of bilirubin. The goal is to keep the level of bilirubin from increasing to dangerous levels. Treatment may include:
While hyperbilirubinemia cannot be totally prevented, early recognition and treatment are important in preventing bilirubin levels from rising to dangerous levels.
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