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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For High Levels Of Bilirubin

HI, i was just gifted with a baby daughter. On the 3rd day when we were in hospital her bilirubin came as 10 and doctors gave us phototherapy . When the Bilirubin came to 6 we got discharged. We were told to get the bilirubin check again after 2 days. We did so and the bilirubin was reported as 14. This was the 6th day and we went to the docs clinic. The doctor said that this is the peak day for bilirubin hence no need to worry . he recommended the bilirubin to be checked again after 36 hours. if it increases then admit here in hospital again. we did so and after 36 hours the bilirub was reported as 26. This was very alarming. We rushed to the hospital after we got the report and they addmitted her in emergency and gave her triple photo light . in 2 hours the bilirubin came to 22 else they were ready for a blood transfusion. Then we remained in hospital 2 more days till the bilirubin came to 8. After that it was 5.9 and we got over with Jaundice. Now doctors are saying that since the bilirubin went so high from 14 to 26 in 36 hours and it was a rare case from them ( i dont know if they are saying the truth) hence they recommend a BERA hearing test. Should i go for it. ? they just want to be safe that the baby didnt got any hearing loss since they consider 26 bilirubin as high
Fri, 30 Jan 2015
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General & Family Physician 's  Response
Hi'
Brief... if high billirubin level is physiological then phototherapy or blood exchange (transfusion) is best treatment.
Detailed answer..
There can be many causes of high billirubin level , which are treated accordingly.For example..if there is jaundice within first 24 hrs of birth ,it is almost always pathological like because of ABO incompatibility; hereditary Hb diseases or hereditary biliary sclerosis etc. If jaundice is after 24 hrs of birth , it can be because of breast milk or physiological as liver enzymes are not mature enough to metabolize etc.
Well first from the history of your child , it seems that she has been suffering from physiological (normal) jaundice , which can be treated with phototherapy and exchange transfusion..But if billirubin level is above 20 it can effect brain so the sensory hearing loss and which can be permanant and non treatable, so better to be on safe side , hearing test should be done , once child is stable.
Regards,
Dr.Maheshwari
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Suggest Treatment For High Levels Of Bilirubin

Hi Brief... if high billirubin level is physiological then phototherapy or blood exchange (transfusion) is best treatment. Detailed answer.. There can be many causes of high billirubin level , which are treated accordingly.For example..if there is jaundice within first 24 hrs of birth ,it is almost always pathological like because of ABO incompatibility; hereditary Hb diseases or hereditary biliary sclerosis etc. If jaundice is after 24 hrs of birth , it can be because of breast milk or physiological as liver enzymes are not mature enough to metabolize etc. Well first from the history of your child , it seems that she has been suffering from physiological (normal) jaundice , which can be treated with phototherapy and exchange transfusion..But if billirubin level is above 20 it can effect brain so the sensory hearing loss and which can be permanant and non treatable, so better to be on safe side , hearing test should be done , once child is stable. Regards, Dr.Maheshwari