The yellow substance that the body of newborns produces to renew their red blood cells is what we call bilirubin, a process is carried out where the liver helps to break down this substance and the waste by the baby’s feces, then this substance will always be present in the body of the newborn, now, what valueis we can considernormal.
For a healthy newborn normal bilirubin levels are according to Maisels, a well-known author who has worked on the subject; these levels are: less than 5mg/dl of bilirubin on the first day, less than 10mg/dl on the second day and less than 13mg/dl from the third day of birth; if any variation in these levels is present, we are in the presence of neonatal jaundice or neonatal hyperbilirubin.
Main types of bilirubin
- Direct or conjugated bilirubin: it is the combined with sugars that is created by the liver and released into the bile, is present in small amounts in the blood and is altered if there is a problem at the level of the liver.
- Indirect or uncon conjugated bilirubin: it is the one that forms at the moment that the red blood cells are destroyed in the blood and then it is taken to the liver, it is in high concentrations in the blood and is altered if there are problems in the blood molecules.
Test to know bilirubin
The first test to be performed to know the level of bilirubin in the newborn is called total bilirubin, this does not differentiate between the types of bilirubin; however, if the total bilirubin appears altered, a test called fractionated bilirubin will be performed, where if the distinction is made between the types of bilirubin: direct and indirect; and in this way know if there is a problem at the level of the liver or blood.
As bilirubin is produced by the liver by destroying red blood cells; it is necessary to perform this test in newborns, to identify if there are liver problems, diseases in the bile ducts or if the baby has hemolytic anemia, and the best way to detect any alteration in bilirubin is the yellow coloration in the skin and eyes of the newborn; this would be an indication that requires the bilirubin test.
Normal bilirubin values in newborns
During the first hours of the baby’s life it is normal that the indirect bilirubin value can reach 5.2 mg/dl, however, if this value is greater than 5mg,the so-called neonatal jaundice arises, which, although it is present during the first weeks of the baby’s life, due to the inability of the liver to eliminate bilirubin, as it is very underdeveloped.
It is important the supervision of the mother and evaluation of the pediatrician, to detect in time any alteration of the normal values of bilirubin; since, if so, the newborn must start treatment immediately through neonatal phototherapy, this therapy is performed by means of a device called a phototherapy lamp, which we at Kalstein, as a company dedicated to the medical field, have for its acquisition, through online purchase and sale.
How to diagnose neonatal jaundice and measure the level of bilirubin
- A physical exam of the newborn.
- Laboratory analysis of a blood sample from the baby.
- By using a device called a transcutaneous bilirubinometer, which serves to measure the reflection of a special light shining through the skin. (skin test).
Treatment for neonatal jaundice
- Improve nutrition.
- Phototherapy. (neonatal phototherapy lamp)
- Intravenous immunoglobulin (IglV)
- Exanguinotransfusión.
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