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Bilirubin Concentration Screening

Bilirubin Concentration Screening

Most newborns have some yellowing of the skin, or jaundice. It is often most noticeable when the baby is 2 to 4 days old. Most of the time, it does not cause problems and goes away within 2 weeks. But, it can indicate a more serious underlying disease.

Who is at risk

Severe newborn jaundice may occur if the baby has a condition that increases the number of red blood cells that need to be replaced in the body, such as:

  • Abnormal blood cell shapes (such as sickle cell anemia)
  • Blood type mismatch between the mother and baby (Rh incompatibility)
  • Bleeding underneath the scalp (cephalohematoma) caused by a difficult delivery
  • Higher levels of red blood cells, which is more common in small-for-gestational age (SGA) babies and some twins
  • Infection
  • Lack of certain important proteins, called enzymes

Things that make it harder for the baby's body to remove bilirubin may also lead to more severe jaundice, including:

  • Certain medicines
  • Infections present at birth, such as rubella, syphilis, and others
  • Diseases that affect the liver or biliary tract, such as cystic fibrosis or hepatitis
  • Low oxygen level (hypoxia)
  • Infections (sepsis)
  • Many different genetic or inherited disorders

Babies who are born too early (premature) are more likely to develop jaundice than full-term babies.

Symptoms

Jaundice is a yellow color in the skin, mucus membranes, or eyes.

What you can do

Contact your doctor if you notice the following symptoms:

  • The jaundice spreads or becomes more intense.
  • Your baby develops a fever over 100°F.
  • Your baby’s yellow coloring deepens.
  • Your baby feeds poorly, appears listless or lethargic, and makes high-pitched cries.

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Newborns

Bright Futures recommends bilirubin concentration screening for newborns.


Why screening is important

High bilirubin levels can be toxic to nerves and cause brain damage.

What the screening is

Most newborn screening tests use a few drops of blood taken from the heel of your baby’s foot.

Treatment

Some infants receive phototherapy, where a physician exposes the baby to a special kind of blue-green light. This is a standard treatment, in which the light converts the bilirubin to a different form that the liver and kidneys can remove.

Additional tips

If your baby does have jaundice, there are ways you can prevent it from becoming more severe:

  • Make sure your baby is getting enough nutrition through breast milk.
  • If you’re not breastfeeding feeding your baby formula, give your baby 1 to 2 ounces of formula every 2 to 3 hours for the first week. Preterm or smaller babies may take smaller amounts of formula, as will babies who are also receiving breast milk.
  • Talk to your doctor if you’re concerned your baby is taking too little or too much formula, or if they won’t wake to feed at least 8 times per 24 hours.

Carefully monitor your baby the first five days of life for the symptoms of jaundice, such as yellowing of the skin and eyes.

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