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Child has yellow stools, increased bilirubin count, watery stools. What to do?

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Hi. My baby girl child is 9 days old. on 5th day, when we made testing for jaundice, the bilirubin content was 13 mg/dl. On 9th day we kept her for photo therapy for 24 hours. now when we did testing on 8th day, it has increased to 14.2. Please advice what to do

Also her motions are normal but it is yellowish dark colour. Also it is not fully solid pasted form. It is more of watery paste. Even we can say the motions are coming like more of Foam. baby is normally urinating but we so far not checked the colour of the urine. She is having normal breast feeding. Since it was cesarean, for first two days, she was given hot pasteurized milk and from second day day, Breast feed is started. Baby was born through Cesarean on 38th week and weight was 3 Kg.

Posted Wed, 3 Oct 2012 in Child Health
Answered by Dr. Sumitra Kumar Mukherjee 57 minutes later
I am sorry to hear about your baby. It appears your baby got physiological jaundice which is staying due to baby being born preterm by cesarean section and baby being breastfed. The physiological jaundice happens due to increased breakdown of red cells and poor function of liver. This is more common in a pre term baby. Breast fed babies (not every baby) tend to remain jaundiced for longer time and that is due to intake less fluid and influence of maternal hormones. Please make sure baby gets extra fluids. So long the baby is not lethargic, feeding well baby will be okay. I think you should check blood again after the baby had phototherapy. Has the baby had any other tests for jaundice? please let me know.
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Follow-up: Child has yellow stools, increased bilirubin count, watery stools. What to do? 47 hours later
Dear Doctor

Please note that my baby already has been undergone for photo therapy. The History is as follows.

Date of Birth was 03.09.2012 on 38th week of pregnancy. It was a cesarean as my wife was given lonopin injection (low molecular weight heparin medications) daily to cover her XXXXXXX + blood.

She has been checked for bilirubin on 7.09.12 ( 5th day of birth) and it was found as 13 mg/dl. Hence the baby has been undergone for photo therapy for 24 Hours from that day evening.

Later on 10.09.12 (8th day of birth) again the test has done but found that the bilirubin level has gone to 14.2.

Again on 12.09.12 ( 10th day of birth) the test has done but still found that the bilirubin level has further gone to 14.97.

Baby is having normal activities. It is sucking and has all other normal activities.

we were not able to kept her in morning sun light except today as here it is raining every morning and the climate is vet in nature.

My doubts are as follows.

1. Normally the bilirubin level used to subsidies from 7th day but in my baby's case the level is still increasing even after being kept her for photo therapy.
( on 5th day Before photo therapy 13 mg/dl. After photo therapy, on 8th day of birth it is increased to 14.2 and on 10th day it XXXXXXX to 14.97). Baby is having normal activities like sucking etc. It is used to feed nearly 10 times a day and drinking only breast milk. Please advice what to do further as we are really scared.

2. What all are the precautions to be taken to reduce the Bilirubin level.

3. Should we go for further again photo therapy for our baby. What would be the usefulness of it. if so how much more hours to be taken. ( please not that already baby has undegone for it for 24 Hours)

Please advice with your valuable clear suggestions.
Answered by Dr. Sumitra Kumar Mukherjee 1 hour later
Dear AAA

You are absolutely right, physiological jaundice usually subsides in a week. I think I mentioned before.

The baby is having prolonged jaundice due to preterm birth 38weeks not 40weeks.

Some breast fed babies tends to have prolonged jaundice. Noting the history I presume, there is no possibility of Rh incompatibility. Next time when you do the bilirubin please let me know both conjugated bilirubin and unconjugated bilirubin levels.

As regard the treatment you can use Bili blanket which is made with fibreoptic pad which can be placed over the body that will do the photo therapy also that will filter harmful rays. I hope your baby will be better soon.

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