What is Bilirubin?

Bilirubin is a yellow pigment created when red blood cells break down—a normal process that becomes dangerous if a newborn's body can't eliminate it fast enough.

Why It Matters in Newborns

  • All babies have higher red blood cell turnover than adults

  • Immature livers struggle to process bilirubin efficiently

  • When levels rise too high (hyperbilirubinemia), it can cross into the brain, causing kernicterus

The Bilirubin Process

  1. Production: Old red blood cells → Unconjugated bilirubin (fat-soluble)

  2. Liver Processing: Converts to water-soluble form for excretion

  3. Elimination: Leaves body through stool (giving newborns' poop that mustard-yellow color)

Danger Signs

  • Healthy Range: <5 mg/dL in first 24 hours

  • Warning Zone:

    • 12 mg/dL at 48 hours

    • 15 mg/dL at 72 hours

  • Emergency: >25 mg/dL risks brain damage

Key Facts Parents Should Know

Visible jaundice starts at levels >5-7 mg/dL
Feeding frequency directly impacts bilirubin clearance
Blood type incompatibilities (like Rh or ABO) can cause rapid spikes

When to Act:

  • Yellow skin below the knees

  • Poor feeding + sleepiness

  • Dark urine/pale stools

Simple blood tests or skin scanners measure levels accurately. Catching rising bilirubin early allows lifesaving phototherapybefore harm occurs.

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Jaundice 101: Moms and Dads, Know this…

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Treating Kernicterus: A Race Against Time