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Newborn and Infant Care

Physiologic jaundice

09/27/2007

Question:

How to handle one day old baby with 15 billirubin,his weight 3.6 kg,and he is 6 days old now,his mother blood type was O and me A,we are from indonesia,plz help me,

Answer:

I cannot tell from your question whether your new baby is one day old or six days old. If he is six days old, it will very much be his doctor's decision on how or even whether or not to treat the jaundice. If he is six days old, it also is unlikely that there is a problem with a difference in blood type between his mother and himself. On the other hand, if he is one day old, such a high bilirubin may well reflect a problem in blood type between mother and baby.

The level of 15 is at the upper end for normal physiologic jaundice for babies older than 3 days of age. I also do not know if your wife is breastfeeding or not. It may be that the high bilirubin level is the result of the baby not having a high enough volume of breastmilk from feeding to promote stooling out of bilirubin as well as the normal red blood cell loss process that all new babies have.

If your son is a day old with such a high bilirubin, your baby will need to stay in the hospital and probably have special transfusion treatments. If your son is six days old, most likely his doctor will want to treat him with light, also known as phototherapy, in order to help get rid of the bilirubin quickly by preparing the bilirubin for release from the body by changing it with light exposure. The doctor will also check on how feeding, stooling, urine output, and weight gain are going since birth. If there are problems in these areas, a home visiting nurse may be helpful to you and your wife to get everyone off to a better start at home. If you live in Ohio, all first time parents are eligible for a free nurse home visit. You can call Ohio Help Me Grow or ask the baby's doctor's office to help you arrange for the visit.

The most common problem with increased bilirubin levels is that the baby may have a hearing loss. So it is important for parents to work together with the baby's doctor to treat the bilirubin level quickly and lower it to a safe level. The bilirubin treatment level has been lowered recently to 15 from 20 to help ensure that no baby has a problem from high bilirubin levels. So prompt treatment should protect your son from any harm.

I hope this is helpful information.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University