NEONATAL HYPERBILIRUBINEMIA (Jaundice)

What is it?
- Hyperbilirubinemia is an elevation of serum bilirubin levels. Bilirubin is a chemical
that is naturally found in our bodies and is responsible for Jaundice, which is a
yellow tinge to the skin, eyes, and mucous membranes. Bilirubin is a byproduct of
red blood cells (RBC) when they die or get destroyed, and it is normally excreted
through feces and urine.
- When there is an excess amount, it presents through our tissues and causes
Jaundice. Newborns have a higher turnover rate of RBC, so they have an
increased RBC breakdown. They also have a higher rate of reabsorption of
bilirubin. These things lead to higher than normal levels of bilirubin in their
circulation.
Is it common?
- About 50%-60% of all full-term newborns are visibly jaundiced during the first 3
days of life. Jaundice first appears after 24 hours and disappears by the end of the seventh day
- About 80% of preterm newborns have jaundice.
Why is jaundice so common in newborns?
- Everyones blood contains bilirubin, and it is removed by our livers. Before birth,
the mothers liver removes all of the babys bilirubin. After birth, it takes some
time for the babys liver to get better at removing the chemical.
- Although usually benign, bilirubin may accumulate to hazardous levels and lead
to pathologic conditions.
Is it bad?
- Neonatal Jaundice is considered benign. However, bilirubin may accumulate to
hazardous levels and lead to brain damage. This is why all newborns should be
checked for jaundice carefully, and treated to prevent a high bilirubin level.

What is the treatment?

- Newborns are treated with phototherapy to help their bodies clear the excess bilirubin.
They are put under a fluorescent light. This light is absorbed by the newborns skin and
helps to convert the excess bilirubin to another form that can be more readily excreted in
stool and urine.

Sources:
Lowdermilk, D. & Perry S. (2013). Maternity & Womens Health Care (8th ed.). St. Louis: Mosby.
Maisels, M. J., Watchko, J. F., Bhutani, V. K., & Stevenson, D. K. (2012). An approach to the management of
hyperbilirubinemia in the preterm infant less than 35 weeks of gestation. J Perinatol Journal of Perinatology, 32(9),
660-664.
RN Maternal Newborn Nursing (9th ed.). (2010). Place of publication not identified: ATI Nursing education.