Bilirubin is a brownish-yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through stool.
When bilirubin levels are high, the skin and whites of the eyes may appear jaundiced (yellow). Too much bilirubin in a newborn baby can cause brain damage (kernicterus), hearing loss, physical abnormalities, and even death. Therefore, some babies who develop jaundice may be treated with special lights (phototherapy) or a blood transfusion to lower their bilirubin levels.
It is not uncommon to see elevated bilirubin levels in newborns, usually one to three days old. Within the first 24 hours of life, up to 50% of full-term newborns, and an even greater percentage of premature babies, may have elevated bilirubin levels. After birth, newborns begin breaking down the excess red blood cells they are born with, since the newborn’s liver is not fully mature, it is unable to process the extra bilirubin, causing the infant’s bilirubin level to rise in the blood and other body tissues. This usually resolves itself within a few days.
Elevated bilirubin damages developing brain cells in infants and may cause learning and developmental disabilities, hearing loss or eye movement problems. There is no need of any special treatment for a mild rise in bilirubin levels or mild hyperbilirubinemia in newborns. To treat moderate hyperbilirubinemia, newborns are required to be placed under bilirubin lights where only the eyes are shielded with a blindfold to avoid any kind of damage.
If elevated bilirubin goes untreated, it often contributes to kernicterus, a rare type of brain damage that will have life-long consequences to the baby and the family. Because there might be medical malpractice, there should be an immediate investigation of the entire labor and delivery process to determine whether this injury could have been prevented.