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How Can Raised Serum Bilirubin Levels In An Infant Be Treated?
Question: HI Team , My baby was born on August 27th 2017 morning 9:32 AM and he is a boy . This baby is Late premature and he was born at 2.07 Kgs .
Query is about his Jaundice Level :
On September 1st 2017 around 12:20 PM - We took him to hospital for Jaundice Test and the reading was13.8 ( I have attached the reports to the query ) and later when I consulted Doctor after the report and he said you can do a retest on Monday Morning and check again if the reading is going beyond 15 - They can perform Photo Therapy , however , today i.e. after 10 hours from Jaundice test we have noticed yellow on his face and this yellowish face was not noticed before the test but after taking test and after 10 hours we are noticing yellow color . Is it emergency to take him to hospital orelse can we wait till MONDAY i.e. 9/4/2017.
For now baby is able to drink milk properly and no concerns in his milk intake and he is pooping and urinating normal .
Query is about his Jaundice Level :
On September 1st 2017 around 12:20 PM - We took him to hospital for Jaundice Test and the reading was13.8 ( I have attached the reports to the query ) and later when I consulted Doctor after the report and he said you can do a retest on Monday Morning and check again if the reading is going beyond 15 - They can perform Photo Therapy , however , today i.e. after 10 hours from Jaundice test we have noticed yellow on his face and this yellowish face was not noticed before the test but after taking test and after 10 hours we are noticing yellow color . Is it emergency to take him to hospital orelse can we wait till MONDAY i.e. 9/4/2017.
For now baby is able to drink milk properly and no concerns in his milk intake and he is pooping and urinating normal .
Brief Answer:
Observe baby and you can wait till monday
Detailed Answer:
Hello
Welcome to HCM
I have seen the reports and do understand your concern.
Raised serum bilirubin or physiological jaundice is common in initial few days of life.
Clinically jaundice starts appearing from face and then gradually progresses down till sole as the level of bilirubin increases.
Face appears yellow when serum bilirubin is more than 5 and it reaches to lower leg at level of 15.
So if you are noticing jaundice in face that is quite normal for a baby with bilirubin of 13.8.
I won't get worried as there is no blood group mismatch between baby and mother & also if we chart the bilirubin level on nomogram( a chart on which plotting the age in hours and bilirubin we can see whether treatment is needed or not) the bilirubin level is below the treatment level. In most of the babies bilirubin reaches its peak at 5 days then starts decreasing.
If we see the rise in bilirubin from 30 th to 1st, it is not very high.
So after taking all these in consideration I think that you can wait for next 48 hours, but if you notice rapid progression towards sole or any significant symptoms like poor feed or excessive lethargy please contact your pediatrician immediately.
I hope this helps.
Please let me know if you have any more questions.
Regards
Observe baby and you can wait till monday
Detailed Answer:
Hello
Welcome to HCM
I have seen the reports and do understand your concern.
Raised serum bilirubin or physiological jaundice is common in initial few days of life.
Clinically jaundice starts appearing from face and then gradually progresses down till sole as the level of bilirubin increases.
Face appears yellow when serum bilirubin is more than 5 and it reaches to lower leg at level of 15.
So if you are noticing jaundice in face that is quite normal for a baby with bilirubin of 13.8.
I won't get worried as there is no blood group mismatch between baby and mother & also if we chart the bilirubin level on nomogram( a chart on which plotting the age in hours and bilirubin we can see whether treatment is needed or not) the bilirubin level is below the treatment level. In most of the babies bilirubin reaches its peak at 5 days then starts decreasing.
If we see the rise in bilirubin from 30 th to 1st, it is not very high.
So after taking all these in consideration I think that you can wait for next 48 hours, but if you notice rapid progression towards sole or any significant symptoms like poor feed or excessive lethargy please contact your pediatrician immediately.
I hope this helps.
Please let me know if you have any more questions.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply and it was very helpful ..!! Now I can sleep :)
Currently his feeding is going good and he is able to drink for 25 minutes continuously every 3 hours and however with respective to Lethargy - He seems to be not so active as yesterday and I find him little Dull but with respect to Consumption of Milk we have no complaint and he is drinking properly .
Do you recommend us to keep him in the Sun morning and please let us know the timing to keep him under sun and for how long ?
Sure , We will be going to Doctor on Monday
Currently his feeding is going good and he is able to drink for 25 minutes continuously every 3 hours and however with respective to Lethargy - He seems to be not so active as yesterday and I find him little Dull but with respect to Consumption of Milk we have no complaint and he is drinking properly .
Do you recommend us to keep him in the Sun morning and please let us know the timing to keep him under sun and for how long ?
Sure , We will be going to Doctor on Monday
Brief Answer:
You can put your baby in sunlight passing through a closed window
Detailed Answer:
Hi
Keeping baby in sunlight as a modality of treatment of jaundice is followed since long.
Now a days it has been seen that direct sun light exposure may cause skin XXXXXXX dehydration and damage of skin by UV rays and so better to avoid direct sun light.
I personally recommend to keep exposed baby in
(a proper warm room to prevent hypothermia) sun light passing through a closed window during morning hours may be upto 30 minute per day.
Proper care should be taken to avoid hypothermia as baby is exposed to open air.
Regards
You can put your baby in sunlight passing through a closed window
Detailed Answer:
Hi
Keeping baby in sunlight as a modality of treatment of jaundice is followed since long.
Now a days it has been seen that direct sun light exposure may cause skin XXXXXXX dehydration and damage of skin by UV rays and so better to avoid direct sun light.
I personally recommend to keep exposed baby in
(a proper warm room to prevent hypothermia) sun light passing through a closed window during morning hours may be upto 30 minute per day.
Proper care should be taken to avoid hypothermia as baby is exposed to open air.
Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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