Hyperbilirubinemia

Hyperbilirubinemia is one of the most common problems encountered in term newborns. Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood. Bilirubin is a tetrapyrrole created by the normal breakdown of heme. Most bilirubin is produced during the breakdown of hemoglobin and other hemoproteins.

Accumulation of bilirubin or its conjugates in body tissues produces jaundice (ie, icterus), which is characterized by high plasma bilirubin levels and deposition of yellow bilirubin pigments in skin, sclerae, mucous membranes, and other less visible tissues. 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.

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. When the baby is born, the baby's liver must take over this function.

There are several causes of hyperbilirubinemia and jaundice. Including first is Physiologic jaundice occurs as a "normal" response to the baby's limited ability to excrete bilirubin in the first days of life. Second is breast milk jaundice and inadequate liver function.

Causes of Hyperbilirubinemia

Common causes of Hyperbilirubinemia

• Blood type ABO or Rh incompatibility Breastfeeding.
• Drugs: diazepam (Valium), oxytocin (Pitocin).
• Gestational diabetes.Hemolysis.
• Dyserythropoiesis.
• Hematoma.
• Portosystemic shunts
• Ethinyl estradiol
• Breast milk jaundice
• Maternal serum jaundice

Symptoms of Hyperbilirubinemia

Common Symptoms of Hyperbilirubinemia

• Yellow coloring of the baby's skin.
• Poor feeding.
• Lethargy.

Treatment of Hyperbilirubinemia

Common Treatment of Hyperbilirubinemia

• Phototherapy may take several hours to begin working and it is used throughout the day and night. The baby's position is changed to allow all of the skin to be exposed to the light. The baby's eyes must be protected and the temperature monitored during phototherapy.
• Your baby's gestational age, overall health, and medical history.
• Extent of the disease.
• Your baby's tolerance for specific medications, procedures, or therapies.
• Expectations for the course of the disease.
• Your opinion or preference.
• Exchange transfusion to replace the baby's damaged blood with fresh blood.

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