Newborn infants will often experience an elevation in their bilirubin (one mother thought it was “belly robin”) levels in the first several days after birth. This makes the baby appear to be yellow or jaundiced.
Parents may hear their nurses discussing a baby’s TcB (transcutaneous bilirubin) level, and some nurses may even show parents the nomogram which the hospital uses to chart bilirubin levels. It seems there is now a lot of anxiety among new parents about what this all means and in most cases the levels are to be totally expected. I continue to think, “too much information for a brand new parent may be harmful to their health”. I want parents to be informed, but only if there is a problem. Is a bili of 7.4 really any different than 8.2? Do you need to be up at night worrying about that? The answer is no - I will be up at night if necessary and let you know. Knowing your baby’s hourly or daily TcB is not necessary and in fact, in my experience they often do not correlate with actual serum bilirubin levels.
Newborn jaundice is due to the fact that infants break down red blood cells in the first several days after birth which causes the release of bilirubin. Bilirubin excretion is also facilitated by the liver, and just like everything else in a new baby....it isn’t in full working mode quite yet. It takes a few days for everything to kick start. At the same time a breast fed baby may be more likely to get jaundiced due to the fact that they often don’t pee and poop as much a formula fed baby....that all corrects itself once the mother’s milk is “in”. Lots of recent articles about this...be reassured.
If your baby does have a problem with higher bilirubin levels, which typically occur somewhere between days 2 -7, then your doctor may recommend phototherapy with special lights that help to breakdown the bilirubin in the skin. This may be done in the hospital or even at home under a contraption called a “bili -blanket”. Once the bilirubin levels drop the lights are turned off!
But, what did our mother’s say long ago, “don’t ask for trouble”. Ask your doctor before you start to worry and remember a little yellow is to be expected.
Here is a picture of one of my newborns in their bili -blanket at home! Looks pretty comfy to me.