What is a Dangerous Level of Bilirubin in Newborns?

Dangerous Bilirubin Levels in Newborns: Symptoms, Causes & Treatment

When your body breaks down red blood cells, it produces a yellowish residue known as bilirubin. Your liver is in charge of processing and eliminating them from your body. However, for newborns, the case is different. Since their livers are immature, they cannot process high bilirubin, leading to jaundice.

Dangerous Bilirubin Levels in Newborns

Doctors suggest that bilirubin levels above 15 mg/dL in 24 hours are harmful for the baby. Moreover, if the levels rise above 20 mg/dL after 48 hours, immediate treatment is necessary.

High unconjugated bilirubin levels in newborn babies can destroy the barrier between blood and brain. It can lead to brain damage.

Symptoms of High Bilirubin Levels in Newborns

Dangerously high bilirubin levels can indicate hyperbilirubinemia. It is a common condition in newborn babies. Symptoms show up as yellowish skin and eyes by the fourth day of birth.

Causes of High Bilirubin Levels in Newborns

There are several causes of dangerously high levels of bilirubin in newborn babies. They are as follows:

• Mismatched blood type of mother and baby
• Lack of enzymes
• Sickle cell anaemia
• Higher than normal levels of red blood cells (common in twins)
• Infection
• Bleeding under the scalp

Before birth, the placenta feeds and clears bilirubin from the baby. However, after birth, this responsibility falls to the liver. Many times, it cannot process the excessive bilirubin produced by red blood cell breakdown. The process of red blood cell breakdown is also known as haemolysis.

Complications of High Bilirubin Levels in Babies

If bilirubin levels are too high, it can cause a myriad of problems and complications. They are:

• Kernicterus (Brain Damage)

Bilirubin levels of more than 20 mg/dL can break the blood-brain barrier. This can lead to permanent brain damage (kernicterus). Symptoms include constant upward gaze, uncontrolled movements, and hearing loss. Moreover, it may also cause defects in the baby's tooth enamel.

• Acute Bilirubin Encephalopathy

When bilirubin passes to the brain, it can cause cerebral palsy. Since the substance is toxic to the brain, it manifests as long-lasting damage to the baby’s growing brain. This includes fever, listlessness, and difficulty walking. Moreover, it can cause the neck and body to arch backwards, along with high-pitched crying. Poor feeding and sucking and fever are also symptoms of acute bilirubin encephalopathy.

Preventing High Bilirubin Levels in Newborns

Although some level of jaundice is common for babies, parents can prevent severe levels of bilirubin in the body.

• Before birth, expectant mothers must test for unusual antibodies and blood type. Rh-negative mothers should test the baby’s umbilical cord as well.
• Parents should feed the baby 8-12 times a day after birth for several days.

Doctors and healthcare professionals must:

• Identify high-risk babies
• Check bilirubin levels at 24 hours.
• Follow up on bilirubin levels within 2 days.
   

Treatment for Dangerously High Bilirubin Levels

In case of extremely high bilirubin levels, doctors may use phototherapy to treat the baby. In this, they place the newborn in an enclosed bed with a blue light on top. This blue light helps break down bilirubin in the skin.

The baby only wears special sunglasses and a diaper during this time. However, mothers can continue to breastfeed. In some cases, intravenous or IV is necessary to transfer fluids to the baby.

Newborn babies are susceptible to jaundice, which is a common occurrence. Most jaundice resolves on its own within 2 weeks. However, when bilirubin levels are too high, immediate treatment is necessary.