Hyper what? Understanding Hyperbilirubinemia.Jun 07 '00 Write an essay on this topic.I know what most of you are thinking. What in the world does that say? Is it really a word? What does it mean? Well, those were my exact thoughts when a nurse came into my hospital room at 6am to tell me that my newborn daughter had something called "hyper-bilirubin-emia". Although it sounds like something an alien might have, it is actually quite common in newborns and infants. In older infants it is more commonly known as jaundice. Hyperbilirubinemia is a more severe kind of jaundice. So, what exactly is it? Well, the process actually starts before a baby is even born. While in the womb, the baby makes more red blood cells than they will need once they are born. After birth these extra red blood cells are broken down by the body. Hemoglobin, the molecule that carries oxygen in the blood is converted to Bilirubin. As the level of bilirubin increases in the blood stream, some of it may deposit in the skin and underlying tissue and the undertone of the baby's skin begins to look yellowish and the white parts of the baby's eyes may also look yellow. This is the most common sign of jaundice. In a jaundiced baby, the level of bilirubin in the blood is generally above 5mg. The level of jaundice is considered excessive when it reaches a serum bilirubin of 17mg/dl and above ( My daughters was 19mg). This is called hyperbilirubinemia. Babies who are naturally bruised in the process of delivery, or have blood type incompatibility with their mother are more likely to get excessive jaundice. (In my case, my daughter had my husbands blood type but she had traces of my blood in her body..thus causing her body to reject her own blood). If my baby has hyperbilirubinemia what can be done? Well, The baby's liver works to clear the extra bilirubin out of the body. It is also cleared as the baby begins to pass bowel movements and the bowel movements begin to appear yellow. The process of clearing the extra bilirubin normally takes from three to five days. The reason that it takes a few days is because while the baby is in the womb, the placenta did the job of excreting toxins from the body, after birth it is the livers job and maturation of the liver takes a few days. Many babies will have at least one blood test before leaving the hospital: so that the physician will have an idea of how well the baby is getting rid of the extra bilirubin and to predict if the baby will be at risk of having hyperbilirubinemia during the first week of life. If the bilirubin level is either low or moderate, your physician will feel comfortable sending the baby home, but will tell you that the blood level needs to be rechecked. (We had to take my daughter to get her heal pricked each morning for the first week of her life). Rechecking is necessary because bilirubin count will go up for the first few days of life. What happens if it is too high or does not go down? If at any time the level is higher than your doctor feels safe for the baby and in order to prevent any harmful effects, they may want to help the baby with the process of clearing away the extra bilirubin. This is done by placing the baby under a special light treatment called phototherapy. These lights work by changing the bilirubin into another less toxic substance which is more easily cleared out of the body. If the baby is under phototherapy, the more time they spend under the lights, the quicker the bilirubin will be cleared away. It will be all right for you to take the baby out of phototherapy for feeding, but then it is best to put the baby back under the lights so the therapy can work as quickly as possible. (While in the hospital, my daughter was under lights for 3 days. When we came home, we had to get a portable phototherapy unit called "The Wallaby Blanket". It looks like a flat plasic paddle filled with lights. We had to put the paddle up her clothes. Every 4 hours we had to rotate sides that the paddle was on. We could not go within 15feet of any eletrical outlet for the first 2 weeks of her life.) How long does it take to go down? Well, usually it can take anywhere from 2 days to a month depending on the severity. Breast feeding can also delay bilirubin from going down. If the baby has hyperbilirubinemia due to opposite blood types, breast feeding can contribute to the levels of bilirubin rising. In most cases, hyperbilirubinemia goes away after several days and causes no lasting health concerns. As with any newborn it is very important to check for signs of jaundice. The quicker you catch it, the easier it can be to treat. I hope that in informing other parents of this, I can eliminate another family having to go through what I went through. I was clueless to this disease and very uninformed. No baby book I read suggested or mentioned anything about hyperbilirubinemia. My daughter is now a happy, healthy 7 month old. I hope that this helps someone.  |
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