
How To Reduce Bilirubin Levels In A Premature Infant?

I have a preterm daughter in 34+6 weeks weighing 2.44g . She looses her weight to 2.2gms. On third day she was diagnosed with jaundice and was given phototherapy. Bilrubin levels were reduced to 13.1 and she was discharged. Again after 2 days bilirubin level increased to 15.5 and she was readmitted for 2 days and was discharged with bilirubin level 7.9 with the help of phototherapy. It has again risen to 12.8 by 20 aug and now it is constant in the range of 11.1.
There are two pblms:
1. How to reduce bilirubin level and by when jaundice will go?
2. Since 25 aug she is having some pblm in passing stool. She applies lot of pressure in passing stool and still no stool is passed. Moreover she is not having proper feed. Taking too lesss at the long gaps.
I m worried. Pls suggest what to do ?
Physiological jaundice - don't worry. Please answer my questions
Detailed Answer:
Hi.... Greetings from XXXXXXX
I have read through your query in detail. I understand your concern. Coming to your queries one by one -
1. What you are quoting is called physiological jaundice. Usually this sort of ups and downs in the bilirubin level is quite common. Usually this will settle by 2 to 3 weeks of age. Sometimes rarely it can get prolonged and this is called prolonged physiological jaundice, then, we need to work up for other reasons like hypothyroidism or breast milk jaundice or fructosemia etc.
2. If you are giving bottle feeding or formula feeding to the baby or you have started doing so, this type of passing hard stool is quite common. Sometime even with exclusive breastfeeding some kids pass hard stool and the too weekly once only.
3. But the other concern is that the baby is not feeding well. For this I need to know the birth weight and the current weight along with exact date of birth of the baby. Please get back to me with these details so that I can guide you further.
Regards - Dr. Sumanth

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