How to Detect Elevated Bilirubin Levels in Newborns

You have a new baby and suddenly another life is completely dependent on you. It’s normal to worry about everything.

But if your newborn baby’s skin and eyes seem yellow, these could be signs of jaundice. WebMD says that jaundice in babies can lead to brain damage, so it’s crucial to diagnose it quickly.

Jaundice is the result of higher than normal amounts of bilirubin (pronounced bill-uh-roo-bin) in your baby’s blood. In extreme cases, it can lead to death.

Here’s how to detect elevated bilirubin levels in your newborn baby.

Yellow Skin or Eyes

Bilirubin is a naturally occurring substance in the body that is yellowish in color. Normally the baby’s liver works to get rid of bilirubin, and it isn’t a problem.

Elevated bilirubin levels in newborns are often discovered in the hospital:

• with a simple light test, or
• by taking a small amount of blood from your baby’s heel.

If the hospital sent your baby home from the hospital within 3 days, the diagnosis could have been missed.

If you think your baby’s skin looks yellow, press one finger on your newborn’s forehead. When you release your finger, see if the skin looks yellow.

On a light-skinned baby, the skin color should return to pink quickly.

It may be harder to see yellowing on a darker-skinned baby. If that’s the case, check the color of the white part of the baby’s eyes, the inner lips, and gums.

Jaundice often starts at the top of the body—visible in your baby’s eyes and head. If you see yellowing further down your baby’s body, call your doctor immediately.

Difficulty Feeding

Over the first week of your baby’s life, you should be seeing a content baby who is feeding eagerly and happily.

If your baby is having a hard time feeding and isn’t getting much nourishment, he or she can lose weight and become dehydrated.

You’ll know your baby is not getting enough milk if you’re not seeing many dirty or wet diapers.

This may cause the baby’s bilirubin level to rise and lead to serious problems.

Sometimes the new mother’s milk is slow to come in. If this happens and the baby is not getting enough to eat, his or her liver may not be able to break down the bilirubin.

Irritability, Fever, and Arching of Neck or Body

It’s normal to worry when you can’t seem to calm your baby down, or if your baby is crying uncontrollably.

If this is happening with your newborn and it doesn’t stop, check to see if your baby has a fever.

There are other reasons for a baby to cry a lot, like colic. But high-pitched, prolonged crying and arching of the back—or a fever—is a reason call your doctor right away. You may need to take the baby to the emergency room or call 911.

What Causes Elevated Bilirubin Levels

Bilirubin levels will be at their highest when your baby is 3 to 5 days old. Most babies are home from the hospital by this time. Your baby must have a follow-up doctor’s appointment within a few days.

Causes of elevated bilirubin levels include:

• Bruising and injuries during delivery
• Internal bleeding
• Infection in the baby’s blood (sepsis)
• Liver malfunction, which may be a sign of hepatitis or cystic fibrosis
• Incompatibility between the mother and baby’s blood
• Premature birth
• Low oxygen level

Newborn jaundice is common—happening in about 60 percent of babies. Most of the time the condition goes away normally and there are no lasting effects.

When the buildup of bilirubin levels in the blood is too high, that signals a problem.

There are factors that make a baby more likely to develop jaundice:

• Premature birth—your baby’s liver may not be able to process the bilirubin if born before 37 weeks (8½ months)
• East Asian or Mediterranean descent
• A sibling with jaundice
• A mother with type O blood or Rh negative blood

What Jaundice Can Cause

If your baby does have an elevated bilirubin level, it can lead to serious complications:

• Acute Bilirubin Encephalopathy. If the bilirubin passes into a baby’s brain, the result can be lasting brain damage.
• Kernicterus or Chronic Bilirubin Encephalopathy. Bilirubin in the brain may lead to:
  • involuntary movements
  • hearing loss
  • improper tooth development.

How Elevated Bilirubin Levels Are Treated

If your baby’s bilirubin level is too high and rising quickly, your baby will need treatment.

Treatment may include:

• Light therapy. Your baby will wear only a diaper and eye protection and be placed under special lights. The lights help break down the bilirubin so your baby can get rid of it in the urine and stool. Sometimes light therapy can cause skin rashes and diarrhea. This shouldn’t last long.
• Intravenous transfusion. If the mother and baby’s blood cells are incompatible, the injection of an immunoglobulin (a protein) can help.
• Exchange transfusion. In rare cases, if your baby doesn’t respond to other treatments he or she may need an exchange of blood. This dilutes the bilirubin. This is considered an emergency procedure and can save your baby’s life.

Your doctor may tell you to feed your baby more often and supplement with formula. Feeding more will help your baby produce more urine and stool and eliminate the bilirubin.

What You Can Do to Take Action

In most cases, an elevated bilirubin level is found and treated early because the symptoms are easy to see. Light therapy and intravenous transfusion are effective and can help avoid serious complications.

If your baby develops an elevated bilirubin level, we want you to know your rights:

• If the medical staff handled your baby’s treatment badly, or if your baby suffered an injury during birth, our legal experts can help you. Birth injuries are one of our key areas of focus.
• Was your baby misdiagnosed? Misdiagnosis is malpractice, and you may be entitled to compensation.
• If your baby received a transfusion and there was an injury, the medical professionals should be held responsible.

Our offices are located throughout New York City, and we offer a free consultation. Don’t hesitate to give us a call. We can put your mind at ease.