When to Treat Hyperbilirubinemia?

Hyperbilirubinemia is a condition in the body that stems from an excess of bilirubin in the blood. Found in bile, Bilirubin is excreted from the liver and, during pregnancy, can be found in the placenta.
Complications from Hyperbilirubinemia include: Jaundice, Kernicterus, Gilbert's disease, Crigler-Najjar syndrome, and Dubin-Johnson syndrome.

Jaundice in Newborns and Detection of Hyperbilirubinemia

If the bilirubin leaks from the placenta, the newborn can develop jaundice. About 60 percent of newborns are reported to have mild jaundice with yellowing of the skin and eyes being the easiest indication of the condition.
According to the American Family Physician, signs of lethargy or poor feeding (early detection); apnea, seizures, or fever (late detection); as well as athetoid cerebral palsy, high-frequency hearing loss, or mild mental retardation (chronic occurrences) can all lead to the detection of Hyperbilirubinemia.

Understanding Bilirubin Levels

Generally, an average level of bilirubin in the body will range from .20 miligrams per deciliter to 1.50 mg/dl. Jaundice usually indicates high levels of bilirubin (eg. 4 to 15 mg/dl).

Treatment

Treating jaundice, especially in newborns, is usually done through photo therapy. Since bilirubin absorbs light, photo therapy uses white, green, or (most commonly) blue light to counter the yellow pigment. This helps to neutralize the bilirubin levels.

Craigler-Najjar and Kernicterus

If untreated, Craigler-Najjar syndrome can give way to Kernicterus, a condition that results when excess bilirubin causes brain tissue damage, seizures and other neurological disorders. (This is especially true in newborns.)
Kernicterus can only be detected with a combination of neurological signs and clear liver tests. If the neurological tests reveal high bilirubin, in spite of clear liver tests, Kernicterus may the cause.
Treatment is needed to prevent the person's neurological functions from deteriorating.

Dubin-Johnson Syndrome

Dubin-Johnson Syndrome is indicated by persistent or recurrent jaundice (combined with clear liver function tests). Upon closer inspection, the tell tale sign is an enlarged liver with dark brown pigment.
Usually no treatment is needed.

Gilbert Syndrome

Gilbert Syndrome is an inherited disease and is a more common issue. It is especially apparent throughout a child's growth, especially if jaundice appears as a symptom alongside other illnesses. The condition is confirmed by shortened survival times of red blood cells.
In newborns, jaundice that is caused by breast milk, is a likely indicator. No treatment is necessary.