Hyperbilirubinemia

TYPES

During pregnancy, it is the mother’s placenta that removes the baby’s bilirubin. When the baby is born, the liver takes on the ability and function. When the liver has reduced ability, the baby may develop the condition. Hyperbilirubinemia can be grouped depending on what causes the disease and jaundice, including the following:

• Physiologic jaundice: A newborn’s liver is immature, especially during the first days of life; hence, the liver cannot quickly filter the bilirubin, causing the accumulation of bilirubin blood. Physiologic jaundice usually resolves by the beginning of the second week of a newborn’s life.
• Breastfeeding jaundice: When a newborn has trouble breastfeeding at first, the baby is at risk for dehydration. This causes the baby to urinate infrequently, and bilirubin builds up in the blood.
• Breast milk jaundice: This usually happens during the first or second week of a newborn’s life and can last up to 12 weeks. It is believed that there may be substances in the breast milk of the mother that impede the liver’s ability to process the bilirubin, though exact reasons are still unidentified.
• Jaundice from hemolysis: The infant may get the condition when there is an increased breakdown of red blood cells (hemolysis) caused by an ABO incompatibility between the infant and the mother.
• Jaundice caused by poor liver function: This happens when the baby’s liver is poorly functioning due to infection or other factors or disease, he may develop the condition.

SYMPTOMS

• Yellowing of the skin, and the whites of his/her eyes
• Poor feeding
• Lack of energy
• Poor weight gain
• High-pitched crying

DIAGNOSIS

Diagnostic procedures for hyperbilirubinemia include:

• Direct and indirect bilirubin levels: blood will be tested to determine the bilirubin level present in the liver or is in the bloodstream.
• Red blood cell count: will determine if the baby has too much RBC which can cause hemolysis
• Reticulocyte count:  determines the level of newly-produced RBS; an indication of RBC production
• Blood type and testing for ABO/Rh incompatibility

TREATMENT

The condition typically resolves after one or two weeks when the child’s liver becomes more efficient and consumes healthy amounts of milk. While in rare cases, the state may last for more than six weeks, even when there is proper treatment. However, this could be an indication of a more serious underlying medical condition that requires more aggressive treatment.

Breastfeeding shall be continuous unless the doctor tells you to stop. Breast milk is required to keep the baby healthy as it supplies all necessary nutrients that will support the baby’s ability to fight off diseases and infections. It is recommended by the American Academy of Pediatrics to breastfeed infants during their first six months, 8 to 12 times per day.