• Hyperbilirubinemia happens when there is too much bilirubin in your

baby’s blood.

• Bilirubin is made by the breakdown of red blood cells. It’s hard for
babies to get rid of bilirubin at first. It can build up in their blood,
tissues, and fluids.

• Bilirubin has a color. It makes a baby’s skin, eyes, and other tissues
turn yellow (jaundice). Jaundice may first appear when your baby is
born. Or it may also show up any time after birth.
• A newborn's immature liver often can't remove bilirubin quickly
enough, causing an excess of bilirubin. Jaundice due to these normal
newborn conditions is called physiologic jaundice, and it typically
appears on the second or third day of life.

• Hyperbilirubinemia is a condition in which there is too much bilirubin

in your baby's blood. When red blood cells break down, a substance
called bilirubin is formed. Babies are not easily able to get rid of the
bilirubin, and it can build up in the blood and other tissues and fluids
of your baby's body.
• Your baby's skin becomes more yellow
• The skin on your baby's the abdomen, arms or legs looks yellow
• The whites of your baby's eyes look yellow
• Your baby seems listless or sick or is difficult to awaken
• Your baby isn't gaining weight or is feeding poorly
• Your baby makes high-pitched cries
• Your baby develops any other signs or symptoms that concern you
• In most cases, a bilirubinometer is used to check for jaundice in
babies. Blood tests are usually only necessary if your baby developed
jaundice within 24 hours of birth or the reading is particularly high.
The level of bilirubin detected in your baby's blood is used to decide
whether any treatment is needed.
• A physical exam.
• A laboratory test of a sample of your baby's blood.
• A skin test with a device called a transcutaneous bilirubinometer,
which measures the reflection of a special light shone through the
skin.
• Bilirubin level monitoring. Regularly monitoring the bilirubin levels in the patient’s blood to assess the severity of hyperbilirubinemia.
• Identification of underlying cause. Investigating and identifying the underlying cause of hyperbilirubinemia to guide treatment decisions.
• Phototherapy. Initiating and managing phototherapy to help break down bilirubin and reduce its levels in the blood.
• Blood transfusion. Considering blood transfusion in severe cases of hyperbilirubinemia to remove excess bilirubin and provide additional red
blood cells.
• Neonatal assessment. Conducting a thorough neonatal assessment to evaluate the overall health and identify any additional concerns
associated with hyperbilirubinemia.
• Parent education. Educating parents about the causes, management, and signs of worsening hyperbilirubinemia, as well as the importance of
follow-up care.
• Liver function evaluation. Assessing liver function to determine if there are any underlying liver disorders contributing to hyperbilirubinemia.
• Coordinating with pediatric specialists. Collaborating with pediatricians and specialists to ensure comprehensive care and appropriate
management of hyperbilirubinemia.
• Support for breastfeeding. Providing guidance and support to breastfeeding mothers to optimize feeding practices, which can help with bilirubin
elimination.
• Long-term follow-up. Planning for long-term follow-up to monitor the resolution of hyperbilirubinemia and identify any potential long-term
effects or complications.
• Several drugs are used as pharmacological modalities for treating
hyperbilirubinemia, like intravenous immunoglobulin, D-penicillamine,
metalloporphyrin, phenobarbital, zinc sulfate and clofibrate. Previous
studies suggest the usefulness of fenofibrate in the treatment of
hyperbilirubinemia.
• For most babies, jaundice will get better without treatment within 1
to 2 weeks. A very high level of bilirubin can damage the brain. This is
called kernicterus. The condition is almost always diagnosed before
the level becomes high enough to cause this damage.