High Bilirubin | Imamother

malky800

Fri, Jul 29 2011, 12:15 am

I had a problem with my newborn because I am blood type A and my husband O, my baby developed very high bilirubin. He was in the hospital for 2 weeks before he was able to come home.

My brother just had his first in a different hospital in a different state. he called me for advice. His baby's bilirubin count is at 14 at 5 days old. She's home now, and the doctor told him to come back in a few days for another test.That's it.

Am I wrong to be concerned. At a 14 count, my baby was not allowed out of the hospital. Why is this baby home and not under any lights.

This is not breastfeeding jaundice, which goes away with formula.

Should I push him to get a second opinion?

I mean , I only had 3 babies to go throug this, but I hope his doctor has more experience than I do.

momomany

Fri, Jul 29 2011, 12:43 am

A bilirubin of 14 at 5 days is not very worrisome.
Your baby's jaundice was a concern because there was a blood incompatibility issue. Such issues can cause dangerously high bilirubin levels. High bilirubin levels are dangerous because it can cause brain damage. However the bilirubin would have to be above 25 (I think) in order for that to happen. If there is no underlying blood problem, then jaundice usually resolves with time. Numbers that would be of concern in a 1-2 day old infant are not a danger to older babies - every day makes a difference. Also, the doctors will be keeping an eye on the bili levels to make sure they are not rising. As long as the numbers are on the way down, it is usually ok.
Sorry to hear about the difficulties that your baby had, but it sounds like your nephew/niece has just plain vanilla newborn jaundice & will be ok.

amother

Fri, Jul 29 2011, 2:28 am

If the number is 14 on day 5 and doesn't go up then it's not such a problem (I believe there are even some Chasidus that make a bris if the baby is 14) as the peaking point at that point has passed, however, if it goes up at this point then there could be a problem.

My son they released from the hospital on time but when I came home my mohel took a look at him day(2.5) and told us to put him under the light. After 12 hours or so he had a bilirubin test and his number was 18 (it most probably was really higher since not enough time had elapsed from when we removed him from the light to when he took the test). From then on he remained under the light continuously except when we undressed him and put him under the sun with lots of gold jewelry on him while partially wearing a red undershirt and giving him some sips of red wine and putting on my nipples vitamin E before a feeding, and feeding very often. The 8th day his number was close to 16. He ended up having his bris 4 weeks later. Had he been my oldest his Pidyon Haben and bris would have been the same day.

The above mentioned things were different ideas from different mohelim that we received.

yaelinIN

Fri, Jul 29 2011, 2:36 am

The medical establishment has revised its ideas of a high bilirubin count over the last couple of years. When I had my first (I also have ABO incompatibility issues), his bili never got above 16 and the MD wanted him under lights at home so we could attempt a bris b'zmano (on time) -- it worked. By kids #4, his bilis were 19 and then they wanted him at the hospital and said now they don't think 20 is the magic number anymore for real worries. Now it is more like 25ish. I was in the hospital with him for 7 days and we raced to have a bris out of our area. The mohel checked him the night before and gave the OK. He has the bris and then we had him rechecked (it's great to have a MD as a best friend to STAT a bili test at the hospital Xmas eve!) and his bili went back up to 20 and we stuck him back under the lights at home for another week. I hope it never happens again!

Maybe you can suggest their MD prescribe them portable bili lights (not really so portable, but much better than being at the hospital!)?

Mazel tov to the family!

MommytoB

Fri, Jul 29 2011, 10:32 am

Echoing what others said. 1 - 2 days old, yes 14 is high. At 5 days old 20 or higher starts treatment. Been through this a few times with multiple testing every day. One of mine got up to 19.6 on day 5 in the afternoon but after nursing, pumping and botle feeding to force hydration over night (only time DC got a bottle!) the # dropped to 16 the next morning and no treatment was neccesary. My newest kept climbing through day 5 and reached 17 or 18 but then dropped. Bilirubin tends to peak around day 5 or 6 (except in rare cases). Blood type incompadibility is not when parents have different blood types but when mother and baby have different blood types.

Bilirubin goes down the more babies poop therefore feeding baby more helps. Jaundice babies are much more sleepy and it is hard to wake them to feed but it is a must in high bilirubin situations.

One last thing, throug they start treatment in the US at 20 and above for babies around 5 days (babies 0 - 2 days I think the # is around 9 or 10), the real # of concern is 25.

malky800

Fri, Jul 29 2011, 11:18 am

I'm not worried that 14 is dangerous yet, I'm just surprised the doctor didn't put the baby under lights even at home. With ABO incompatibiltiy why isn't the doctor being more pro-active?