Jaundice is a yellowing of the skin caused by a build up of bilirubin in the bloodstream. Infants typically experience slight jaundice after birth with no long-term risks. However, severe cases of jaundice require medical intervention. Left untreated, jaundice can cause cerebral palsy, brain damage or deafness. Learn to use a Biliblanket to break down excess bilirubin in your infant.

Instructions

1

Familiarize yourself with the Biliblanket and its various parts. The fiber-optic pad is the part that goes directly on the infant's skin. The light generating box produces the phototherapy light and should be placed on a flat surface. The connector cable joins the two parts and should be free of defects.

2

Double-check with your pediatrician how long and how often your infant should be under the Biliblanket. The severity of the jaundice will be the determining factor.

3

Remove the infant's clothes except for the diaper and wrap him in the Biliblanket. You can rock, nurse or bottle feed while he is under the Biliblanket.

4

Cover the infant's eyes to avoid exposure to the light. Use the cloth eye pads or eye coverings your hospital or physician can provide.

Jaundice is very common in newborn babies, as half of all newborns end up developing some level of jaundice. The symptoms of jaundice are clearly visible and cause yellowing of both the skin and eyes. Jaundice is a disease that indicates that a baby's liver isn't mature enough to metabolize a molecule called bilirubin. Newborns who are unable to recycle bilirubin will develop jaundice.

Premature Birth

A premature newborn has a risk for jaundice, as newborns who are born early are not always able to process bilirubin as well as a full-term newborn. A premature newborn will eat less than a full-term newborn, and have fewer bowl movements.This will result in a limited amount of bilirubin passing through a newborn's system through the baby's stools.

Breastfeeding

Although breastfeeding is much more healthy for a baby than bottle feeding, it does cause a higher risk for jaundice, especially for those infants who are having trouble latching on and taking in enough milk. This will keep a baby from getting the right amount of nutrition, causing jaundice.

Blood Type

Mothers who have a different blood type than their newborn can also contribute to a newborn getting jaundice. This ultimately causes the placenta to transfer antibodies to the unborn baby, which causes the newborn's blood cells to break down faster, resulting in jaundice.

Mongolian spots are bluish-black, flat birthmarks in irregular shapes that occur mostly in infants of Indian, African and Latino heritage. Mongolian spots can be seen on various parts of the body of newborns. Sometimes infants are born with Mongolian spots, or the spots appear shortly after birth.

Instructions

1

Note that Mongolian spots usually fade within a few years and are typically gone by puberty. Occasionally, they remain into adulthood, but there is no need for treatment to make them fade or disappear.

2

Recognize Mongolian birthmark spots on infants as flat dark brown, dark gray or blue-black spots. They commonly appear on an infant's buttocks, lower back, shoulders, legs and sides. They can range from very small spots to large areas of deep, dark areas of skin.

3

Realize that Mongolian spots are benign markings and carry no complications or risk factors. They are birthmarks and are not associated with any disease or illness.

4

Be aware that Mongolian spots are easily mistaken for bruises and may trigger child abuse accusations. Make sure the child's pediatrician documents the Mongolian spots and includes detailed information in the child's health records.

5

Understand that Mongolian spots are non-cancerous. They do not require treatment, and they cannot be prevented. They are not related to bruises or any additional medical problems. Further complications from Mongolian spots do not appear later in life.

Jaundice in newborns is common. It occurs to almost every baby in the first few days of life. Jaundice is not a disease. It refers to the color of the skin or white parts of the eyes called the sclera. Babies of all races develop jaundice though it is harder to see it in darker skinned infants. The best way to check the color is in bright sunlight or under fluorescent lighting. Unless you have seen many, many jaundiced babies, it is not that easy to spot. If someone comments that your baby has "a beautiful skin color" it is wise to ask if he is jaundiced. Mild jaundice is not harmful.

Causes

Jaundice is the result of elevated levels of bilirubin in the infant's blood. This is a normal finding and due to the baby having to process her own bilirubin for the first time. Before birth, her mother's liver did it for her and her own immature liver is just beginning to take over. A baby who has a great deal of bruising from delivery or had a vacuum extraction will likely have higher levels of bilirubin. There are some rare metabolic diseases that cause elevated bilirubin levels and those babies are usually markedly jaundiced before 24 hours of age.

Testing

Your baby will have a blood test for bilirubin levels at 24 hours and at 48 to 72 hours. If you and your baby are discharged from the hospital prior to 72 hours, the pediatrician or nurse practitioner will want to see him within two days to repeat the test. The American Academy of Pediatrics recommends this practice and it is performed in nearly every hospital in the United States. Without screening, elevated bilirubin levels that go undiscovered may lead to a dangerous neurological condition called Kernicterus. Fortunately, this is rare.

Management

Usually, no treatment is required. For all babies, it is important to keep the infant well hydrated, see that he is breastfeeding or bottle feeding well and having plenty of wet and soiled diapers. In the case of an elevated bilirubin outside the accepted range, phototherapy may be required. There are several ways to do this. In one situation, the infant lies in an isolette with ultraviolet lights on. It looks very much like she is lying in a tanning bed especially since she will be wearing eye shields. There are also phototherapy lamps and blankets, which may be used. The doctor will order the method that is right for your baby's bilirubin level. Hydration is especially important under phototherapy.

When to Call the Doctor

Once you are home, it is important to call your infant's doctor if he appears more jaundiced especially on his legs, arms or belly. If the whites of his eyes are yellow, it warrants a call as well. Breastfed babies are statistically more likely to become jaundiced although no one knows for sure why. Breast or bottle fed, if your baby is not feeding well or becomes especially sleepy, call the doctor.

Misconceptions

Newborns have always been jaundiced and have mostly done fine. For a period of time, routine bilirubin testing was discontinued and more babies developed consequences of very high bilirubins that were not treated. It is never adequate treatment to place a jaundiced baby by a sunny window. Newborns who are jaundiced because they have elevated bilirubins need to be managed by their doctors or nurse practitioners to prevent damage and disability.

Developmental disabilities encompass a large group of issues that children and adults face; they are defined by the Centers for Disease Control and Prevention as a "diverse group of severe chronic conditions that are due to mental and/or physical impairments." Many disabilities fall under this umbrella, and they usually result in a permanent disability the child must live with all of his life. They must be diagnosed during the child's developmental period. Children with these disabilities may lead relatively normal lives, requiring little to no intervention, while some may require extensive intervention and accommodation.

Definition

The Centers for Disease Control and Prevention lists developmental disabilities as those that fall under fall under one of a few categories, including the autism spectrum (which includes all levels of functioning within autism), cerebral palsy (a disability affecting the use of muscles), hearing loss, visual impairments, degenerative disorders (such as muscular dystrophy in which muscles gradually lose their use) and intellectual disability (any disease or condition that slows down the child's brain development, such as Down syndrome or Fragile X syndrome). These diseases or disabilities must be diagnosed during development, from infancy to 21 years of age.

Types

The Metropolitan Atlanta Developmental Disabilities Study (MADDS), the first major study on the prevalence of developmental disabilities in children, created criteria for each developmental delay. This criteria says an intellectual disability is classified as testing an IQ (intelligence quotient) of less than 70. Cerebral palsy is qualified by MADDS as: "The impairment of motor function may result in paresis, involuntary movement, or incoordination." Motor disorders are classified as "disorders that result from progressive diseases of the brain, and motor disorders due to spinal cord abnormalities or injuries are not included." Hearing loss must average 40 decibels or worse, vision impairment much be 20/200 or worse vision with correction. Those with epilepsy must have suffered from two grand mal seizures in their lifetime in order to be considered a developmental disability by MADDS.

Statistics

According to MADDS, 10 percent of school-age children suffer from a developmental disability. Because of the range of the disabilities, it is difficult to pin down exact numbers, however wrongdiagnosis.com estimates that 5,000 children with Down syndrome are born each year (attributed to Association for Children with Down Syndrome) and one in 500 people suffer from autism (statistic attributed to the National Institute of Mental Health), which is almost always diagnosed during the developmental period. Dr. Spock estimates that most autistic children are diagnosed between the ages of two and three.

Prevention

Although many developmental disabilities cannot be prevented, the Centers for Disease Control and Prevention say that jaundice/kernicterus, which can lead to brain damage in newborns, is preventable. If you suspect your baby has jaundice, early intervention can prevent developmental disabilities. In addition, education programs about the use of drugs and alcohol during pregnancy can help further prevent developmental disabilities caused by the use of such substances. The Centers for Disease Control and Prevention also recommend early screening by a health care professional in order to make the most of early detection and intervention. However, many developmental disabilities cannot be prevented because there is no known cause for the disability (as in autism), or the disability is hereditary (with Down syndrome).

Defining Disabilities to Your Students

If you have a student who has been integrated into a non-special education classroom and has a developmental disability, it is a good idea to keep the lines of communication open between you, his parents, his doctors and the other students in his class. Some students with developmental disabilities may want the class to know ahead of time so they can be prepared to deal with the difficulties of his illness, while others may want to "slip by" unnoticed. Talk to the student with the developmental disability and get his take on it. Do not choose to tell or not tell your class without consulting your student and his family first.

The cognitive development of an infant child is the first step in creating the foundations of learning language, memory, reasoning and thinking, according to the Centers for Disease Control and Prevention. Also, during the critical stage of an infant's life, up until one year of age, he is learning how to bond with his parents or with a caretaker. There are certain illnesses that may negatively affect the cognitive development in infants.

Warning Signs

When a baby is a year old he should be able to display responses to easy spoken requests, hit two objects together, find pleasure in copying people, and sit up with out help, reports the Centers for Disease Control and Prevention. When an infant is not able to exhibit these behaviors by the age of one, he has a development delay. Developmental screening (observing the baby's behavior) should be performed by a doctor or nurse to assess the situation and possibly link it to a certain cause. It is important to find the source of the problem early on, and prevent it from getting worse, in cases where it can be helped.

Behavioral Disabilities

There are several behavioral disabilities that affect a baby's ability to develop properly.

Autistic Disorder, more commonly known as autism, causes people to process information very differently than others. It may lead to problems with language development, uncommon behaviors and social issues. Autism varies in its degree of severity. One of the early signs of autism is when an infant does not react to her name after a year.

Intellectual Disability causes significant delays in a child's development, stunting her cognitive development very early in life. Down syndrome, fetal alcohol syndrome, genetic conditions and birth defects are causes for intellectual disability.

Attention-Deficit/Hyperactivity Disorder (ADHD) leads to difficulty in focusing, rash behavior and excessive activity. Brain damage, early delivery and alcohol and tobacco intake by the mother during pregnancy are some of the possible causes for ADHD.

Cerebral Palsy

Cerebral Palsy affects the ability to move muscles effectively. An infant under three months who has trouble managing the movement of his head when he is picked up, and legs that cross in a scissor pattern, are signs that the baby may have cerebral palsy. Brain damage or development difficulties may cause cerebral palsy.

Vision Loss

Vision loss may occur in rare cases, from retinopathy of prematurity (ROP), the scarring of the retina. Premature babies are at high risk for ROP, states Dr. Gary Heitling in optometry. An infant with vision loss will have delays in cognitive development, because the infant won't be able to associate words with people or objects.

Hearing Loss

Hearing loss may occur temporarily from an ear infection, which causes the build-up of fluids in the ears. If an infant is not able to hear for periods of time, it will impair their ability to start understanding the beginnings of language, part of their cognitive development. Measles, meningitis (an infection of fluid close to the spinal cord and brain), and kernicterus (brain damage) may lead to hearing impairment. All these can be prevented or helped with vaccines and certain therapies.

Although jaundice is common in newborns, it can also affect adults who lead unhealthy lifestyles. Jaundice occurs when your liver is incapable of removing bilirubin from your body. The bilirubin builds up in your liver and causes your skin and eyes to take on a yellow tinge (Reference 2). Following a healthy diet and avoiding factors that can lead to liver disease may help prevent jaundice. If you develop jaundice, though, contact your health professional.

Foods to Eat

According to ayurvediccure.com, fruits can help prevent jaundice, as they help to cleanse the body of toxins. Regularly incorporate pears, apples, grapes and pineapples into your diet. Also, citrus fruits such as oranges help prevent the production of bilirubin (Reference 1).

If you already have jaundice, ayurvediccure.com recommends that you do a juice fast. During the fast, consume nothing but fruit juice until your jaundice subsides. Then, eat only fruit for at least three days. Once you start to eat other foods, consume a piece of fruit with every meal (Reference 1). A juice fast can also be undertaken if you have a history of recurring jaundice.

Drink at least eight glasses of water a day. This will flush toxins that lead to jaundice out of your system. Coconut juice and barley water also help eliminate toxins from your body (Reference 1).

A healthy diet filled with green leafy vegetables can help prevent jaundice. If you do not care for vegetables, drink vegetable juice (Reference 1). Regular exercise and sleep enhance the effects of a healthy diet (Reference 2).

Foods to Avoid

In some cases, alcohol consumption causes jaundice, as this damages the liver. If you have liver damage, you need to stop consuming alcohol immediately; otherwise you may require liver surgery (Reference 2).

Excessive amounts of caffeine and sugar can affect your liver and cause jaundice. Limit your intake of soda, tea, coffee and other beverages that contain caffeine or artificial sweeteners (Reference 1).

Processed foods, saturated fat and fried foods can stress your liver, possibly leading to jaundice. Eat whole foods whenever possible and limit fatty meats. According to ayurvediccure.com, a diet high in meats disrupts your digestive system, thus decreasing your body's ability to remove toxins (Reference 1).

Legumes and pulses should be limited, as they also disrupt your digestive system (Reference 1).

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.

For newborns with jaundice, or a yellowing of the skin, fiberoptic phototherapy presents an alternative to conventional phototherapy that is safe, effective and might be more convenient for parents.

Indications for Fiberoptic Phototherapy

Fiberoptic phototherapy is used to treat newborn jaundice. This condition is also called hyperbilirubinemia because it is due to an abnormal elevation of bilirubin, a chemical found in the blood. Too much bilirubin leads to specific type of brain damage called kernicterus.

How Fiberoptic Phototherapy Works

Most cases of jaundice are easily treated with phototherapy.

When light of a specific blue wavelength is directed at a baby's skin, the light energy changes the bilirubin molecule so that the baby can excrete it in the urine, lowering the dangerous bilirubin level in the blood. Fiberoptic phototherapy consists of flexible fiberoptic lights that emit a blue color. Because the lights can be applied directly next to the skin of the baby and covered with a blanket, fiberoptic phototherapy is often referred to as a "bili blanket."

Conventional Phototherapy

Before fiberoptic phototherapy was invented in 1989, conventional phototherapy was used, which consists of a large bank of lights positioned over the baby's crib or bassinet. When using this kind of phototherapy, the baby spends most of the time in the bassinet, with her eyes covered to prevent damage from the light, and often has to stay in the hospital.

Benefits of Fiberoptic Phototherapy

With fiberoptic phototherapy, the baby can be fed and held normally, and is often treated at home rather than in the hospital. The fiberoptic panel position can be changed frequently so that the baby's entire body gets phototherapy during the course of treatment. In addition, the effectiveness of phototherapy is inversely related to the distance between the light and the skin, so fiberoptic therapy may be more beneficial than conventional phototherapy.

Side Effects

Fiberoptic phototherapy is very safe, but side effects include mild diarrhea, increased water loss, skin irritation, and bronzing of the skin. These all resolve when the lights are stopped.

Jaundice is a condition that turns skin yellow. More than half of all newborns acquire some type of jaundice during the first week of life, according to the University of Virginia Health System. While jaundice is commonly associated with newborn infants, the condition can affect a person of any age, race and color, and could be a sign of health issues.

Causes

Jaundice is caused by an overabundance of bilirubin in the body. Bilirubin is a yellow chemical found in hemoglobin, the substance that transports oxygen in the red blood cells. As red blood cells decompose, the body creates replacement cells. The older cells are treated by the liver. If the liver cannot deal with the blood cells as they decompose, bilirubin increases in the body giving the skin a yellowish appearance. A newborn will often develop jaundice because their liver enzymes are not developed enough to breakdown the red blood cells.

Effects

Jaundice in most cases is not harmful and has no long-term effects. Doctors carefully keep an eye out for jaundice and are aggressive in treatment. High bilirubin levels can lead to seizures and kernicterus, a condition where the toxic levels negatively affects the development of a baby's brain. Occasionally, a baby will develop jaundice for a rare reason, such as through infections or trouble with the thyroid gland. In these instances, an infant can develop long-term effects from these complications, not from the jaundice.

Symptoms

General symptoms of jaundice include a yellow tint to a person's skin, often starting on the face and progressing down the body, tiredness and lack of appetite. Symptoms of jaundice can look like other medical conditions. If there is any doubt, consult your physician.

Diagnosis

In the majority of instances, jaundice can be diagnosed visually through a person's skin color and eyes. A physician can detect jaundice by feeling for enlargement of the spleen and liver and to see if there is any pain in the abdomen. More detailed ways to detect jaundice is through blood tests or a bone marrow biopsy. In cases where it is unclear if jaundice exists, an ultrasound of the spleen will reveal a definitive answer.

Treatment

Treatment for jaundice depends on a variety of scenarios, such as the cause and the level of bilirubin. Treatment aims to prevent bilirubin level's from increasing to dangerous proportions. There are various ways to treat jaundice. One way is to use phototherapy. With phototherapy, a person is exposed to distinct blue lights. A person's entire body is exposed to the special light and the eyes are kept protected. A blood transfusion can also help with jaundice. New blood can help to raise the red blood cell and lower the amounts of bilirubin. Another method of curbing jaundice is to stop breastfeeding an infant with jaundice. If an infant drinks formula for a few days, it can decrease bilirubin levels.

Kernicterus is a form of brain damage that is found in newborn babies. When babies are born, their livers begin developing a yellow waste product called bilirubin. When there is too much bilirubin being produced, the skin and the whites of the eyes begin to turn yellow which is referred to as jaundice. It is not uncommon for a newborn baby to have a minimal bout with jaundice when they are first born, but if the liver continues to produce too much bilirubin, then kernicterus will develop.

Blue Lights

Doctors have a high level of success in averting kernicterus from developing to the point of causing serious damage. To prevent persistent jaundice from becoming kernicterus, the hospital will expose the baby to special blue lights that are designed to warm the baby and decrease the amount of bilirubin in the system. This treatment is not harmful to the child, and since the blue lights emit heat, it is very possible that the baby enjoys the treatment. The amount of milk the baby consumes is increased to offset the loss of nutrients due to the exposure to additional heat. Within a few days, or a couple of weeks, the jaundice has subsided and the kernicterus has been averted.

This treatment can be performed either in the hospital or at home. The decision on where the treatment should be performed is at the discretion of the doctor.

Blood Transfusion

It may be that the jaundice has reached an extreme level and the formation of kernicterus is possible. If the doctor determines that the presence of bilirubin is too high for blue light therapy, then she will perform a blood transfusion to immediately reduce the bilirubin in the system. This procedure is safe to the baby, and it is only done under extreme circumstances.

Risk Factors

Not every baby gets jaundice when born, but there are a few circumstances when the possibility of contracting jaundice is higher than in other cases. If a baby has a sibling that was born with jaundice, then that baby is more likely to contract jaundice. A baby born with bruises is very likely to contract jaundice. Jaundice happens because red blood cells die and bilirubin is the waste product of the break down of dead red blood cells. A bruise on a newborn baby means a blood vessel broke under the skin, and there are a tremendous amount of red blood cells being created and dying. This excess of dead red blood cells causes an excess in bilirubin, which causes jaundice.

Jaundice is a very common condition affecting newborns. It is not dangerous in most cases, as it is simply a reaction to too much pigment, or bilirubin, in the body. The excess amounts of pigment cause an alarming yellow tinge to your baby's skin; however, never fear, as there are ways that you can fight jaundice safely and effectively.

Instructions

1

Allow your newborn's body to fight the jaundice by keeping him in a well lit area for 15 minutes at least twice a day. Sunlight naturally aids the body in the breaking down of bilirubin so that the liver can more easily process it. Often just exposure to sunlight is enough to eliminate yellowing skin.

2

Speak to your doctor about special sun lamps, or phototherapy lamps, if it proves difficult to expose your child to sunlight, or if two sessions of sun exposure doesn't seem to be helping. With special monitoring and the advice of your doctor, the addition of these lamps to your home can greatly assist in the treatment of jaundice.

3

Breast feed your baby if at all possible, as your milk contains vital nutrients that your newborn's body needs to not only fight jaundice but to grow strong and healthy.

4

Consider special formulas that can supplement regular feeding and breast feeding which are specially designed to help fight jaundice. Before switching or supplementing formulas, it is a good idea to speak with a lactation consultant or your pediatrician about all the possible special feeding options.

Frontal Lobe Development

The frontal lobe just behind the forehead controls walking, talking, socialization and understanding. This side of the brain progresses between ages 6 to 12 months. The left side controls language, and the right side special abilities. In girls, the left side is thought to develop sooner than in boys, and vice versa.

Parietal Lobe Development

The parietal lobe of the brain helps babies' fingers learn how to grasp between the ages of 2 to 12 months. This is the side of the brain which also controls sight. Initially, babies are unable to focus past 8 to 15 inches. Over time, vision improves, and they are able to focus on stationary and moving objects. By 8 months, their vision has 20/40 equivalency.
This is the part of the brain which also governs understanding. At about a year, babies recognize simple commands and may also be able to respond.

Occipital Lobe Development

The occipital lobe is another spot of the brain, located in the back of the head, which takes care of vision. In the first year, babies can see colors and develop depth perception. Books and mobiles in bright, primary colors are excellent for strengthening and stimulating vision in the first year.

Temporal Lobe Development

Hearing, speaking and the ability to be independent are skills which are acquired with this part of the brain. From the moment babies are born, their hearing is acute. The sense of smell is also strong in babies from birth. Within 10 days, they recognize the scent of their mother's milk.
Babies begin learning vocalization in the womb. It continues from early age, when they learn to cry as a way to communicate. Eventually babies babble and then learn to form words. Reading to babies encourages language development, as well as improves listening skills.
Babies gain their sense of independence and learn that they can make independent movements of parts of their body or move their entire body.

Cerebellum Development

The cerebellum, located at the back of the head, helps with movement and muscle coordination. Activities such as crawling, walking, head control, sitting and rolling over develop during infancy. Research indicates cardiovascular activities may also be developed from the cerebellum.

The Brain Stem

An infant's brain stem is the portion of the brain that is most developed at birth. It controls emotion and also the crying, suckling and startling reflexes. It also controls basic life functions, such as heart rate, blood pressure and sleep.

What Is Bilirubin?

Bilirubin is a by-product of the process in which hemoglobin, a protein in red blood cells is broken down. The liver is responsible for removing bilirubin in the blood, therefore when levels are elevated, it can be the sign of a liver disorder. Signs of elevated levels of bilirubin include yellowing of the skin, dark urine, vomiting, abdominal pain, or chronic fatigue.

Elevated Levels in Newborns

Jaundice is a common disorder that occurs in newborns. A newborn's liver is not yet fully developed, therefore the infant is not able to sufficiently process the red blood cells that are produced when he or she is born. Jaundice occurs when bilirubin levels reach 2.5 mg/dL or greater. This can manifest itself in the baby's skin appearing yellow in color. As extremely high bilirubin levels are associated with brain damage, it is important to seek medical treatment for jaundice.

Blockage of Bile Ducts

Bile is the by-product released by the liver that contains bilrubin as well as cholesterol, bile salts, and other waste products. If the bile ducts are blocked due to causes such as gallstones, pancreas or bile duct tumors, cysts, inflammation, or injury due to surgery; bilirubin builds up in the liver and causes increased levels.

Liver Diseases

Liver disease such as cirrhosis, which is due to excessive alcohol consumption, or hepatitis, which affects liver function. Both of these disorders contribute to elevated bilirubin because these disorders kill off liver cells and cause scarring. The decrease in liver cells can impair liver function, resulting in increased bilirubin levels.

Inherited Health Disorders

Some genetic disorders affect the liver's ability to function properly or process bilirubin, such as Crigler/Najjar syndrome, Erthroblastosis fetalis, and Gilbert's disease. While each affects the liver in different manners, all involve the inability to properly break down bilirubin in the body, increasing levels.

The liver is the second largest organ in the human body, and it performs some very important tasks. One of those tasks is recycling hemoglobin and other chemicals for later use. When the liver is damaged, a byproduct of the recycling process builds up in the blood. A number of conditions, each with a different treatment, lead to liver damage.

Bilirubin

Bilirubin is a chemical created from the breakdown of red blood cells. Bilirubin is processed in the liver into a less toxic form and then excreted into the small intestine in the form of bile. Bile helps in the absorption of fat. When the liver is unable to excrete bilirubin because of disease, the concentration of bilirubin in the blood rises.

Hyperbilirubinemia

High concentrations of bilirubin in blood, known as hyperbilirubinemia, result from liver damage. Bilirubin at high concentrations may cause kernicterus, a condition in which brain damage results. A person with hyperbilirubinemia has yellowing of the skin, known as jaundice, since bilirubin is yellow. As the condition gets worse, disorientation and other neurological symptoms ensue. Properly diagnosing the cause of hyperbilirubinemia is important in treatment.

Hepatic Toxicity

One form of liver damage is hepatic toxicity. The most common kind of liver toxicity results from alcohol use. While the liver is able to repair damage from excess consumption of alcohol, the repairs can only be performed to a certain extent. Scar tissue eventually destroys the liver ability to function, a condition called cirrhosis. Other chemicals such as medications and chemical solvents also cause hepatic toxicity.

Viral Infections

Infection with hepatitis viruses also cause liver damage. Hepatitis A, which is acquired through the consumption of contaminated food or water, causes short term jaundice while the liver gets over the infection. Hepatitis B is a blood-borne viral infection which may lead to liver damage in some people. Hepatitis C is also a blood-borne viral infection, and it is a known cause of liver cirrhosis.

Neonatal Jaundice

According to the University of Virginia Health System, up to 60 percent of newborns may develop hyperbilirubinemia, known as neonatal jaundice, because their livers are not fully developed. In the womb, the placenta performs the function of the liver in getting rid of excess bilirubin. As the newborn's liver takes over, the jaundice resolves.

Treatments

Treatment of hepatic toxicity depends on the level of toxicity. Mild cases resolve on their own while severe cases may require a liver transplant. Hepatitis A resolves on its own, usually without complications. Hepatitis B and C may be treated with antiviral medication. However, they sometimes develop into cirrhosis that requires a liver transplant. Finally, neonatal jaundice is treated with light therapy while the liver begins to function on its own. This is because white light helps make bilirubin water-soluble for excretion through the kidneys.

Phototherapy light teatment is conducted by placing a patient in front of a bright light for a prescribed period of time and is effective at treating seasonal affective disorder.

Function

Phototherapy light treatment augments a patient's neurochemicals by exposure to specific wavelengths of light that are identical to natural daylight. Researchers believe the artificial daylight produced improves mood and alleviates depression associated with people who do not receive enough exposure to natural daylight.

Benefits

Patients who undergo light therapy do so as a standalone treatment or to enhance current antidepressant therapy such as medication. Patients who cannot take antidepressant medications can undergo phototherapy light treatment.

Theories/Speculation

Although science has not been definitive, phototherapy light treatment is being studied as a possible treatment for conditions such as obsessive compulsive disorder, sleep disorders, Parkinson's disease and dementia.

Significance

Jaundice is caused by an excess of bilirubin, a yellow-orange pigment in the blood resulting from the normal breakdown of hemoglobin in red blood cells. The more the disintegration of red blood cells, the higher the concentration of bilirubin.

Physiological jaundice of the newborn is common. Jaundice occurs most often in preterm infants born before the 36th week and premature babies weighing less than five pounds. Because the excess red blood cells babies are born with are being broken down, the infant's liver is not mature enough to process the extra bilirubin being produced. In some cases, jaundice may be due to hemolytic disease, occurring when the mother and baby have different blood types. Faster breakdown of red blood cells will take place in this circumstance, resulting in elevated bilirubin levels.

Identification

Initial diagnosis of infant jaundice is based on the baby's appearance. The excess pigment in the blood causes a yellowish discoloration of the skin and eyes. In most instances, the bilirubin levels fall to normal within a few days as the overabundance of red blood cells diminishes and the liver matures.

Procedure

In infants, increased levels of bilirubin can lead to brain damage and hearing loss. The doctor will order a blood test. A lab technician will prick the baby's heel and gently squeeze blood into a test tube. The sample of blood is taken to the laboratory. Cells are separated from the liquid serum. The test is performed on the serum to determine the concentration of bilirubin. Charted norms are used that identify the specific age of the infant in hours and the bilirubin level. The chart, called a Bhutani nomogram, predicts the likelihood of the infant to produce even higher concentrations or the probability that the levels will diminish safely on their own. In a newborn, the specific amount of bilirubin in the blood is not significant on its own. The time line established by the nomogram determines the risk for acquiring forthcoming severe or acute levels.

Types

Prior to reaching the liver, bilirubin is referred to as indirect, or unconjugated, and does not dissolve in liquid. Direct, or conjugated, bilirubin has been processed by the liver into soluble form. It is then released as bile and stored in the gall bladder until it is excreted into the large intestine to be eliminated from the body.

Treatment

Phototherapy, treatment with a special blue light, is prescribed for babies with high levels. The light alters the composition of the bilirubin, enabling the liver to process the pigment more effectively. Emphasis is placed on good nourishment through successful breastfeeding. In rare cases, blood transfusions are warranted.

Kernicterus is a disease in newborns that leads to brain damage if not treated promptly. The problem stems from the baby's liver when it hasn't developed entirely before birth. During gestation, old bilirubin from the baby is filtered in the mother's liver. If a baby is born prematurely and the liver has not developed, the liver is not capable of filtering old bilirubin, so jaundice occurs. If not treated, jaundice leads to brain damage in the newborn.

Symptoms

Jaundice is characterized by a yellowing of the skin and the white part of the eye. It begins in the face and spreads to the chest, neck, and arms. Babies with darker skin may be more difficult to notice jaundice, but it can be seen in the eyes. As the bilirubin continues to accumulate in the blood, the jaundice gradually spreads to the entire body.

Brain Damage

According to the Center for Disease Control, 60% of babies develop jaundice. Jaundice is common in newborns as their liver adapts to clearing the body from excess bilirubin. Mild jaundice is not harmful, but severe jaundice left untreated reaches the brain and causes damage.

Risk Factors

Although most babies develop some type of jaundice, risk factors increase the chances of the kernicterus. Risk factors are mostly hereditary. If a baby is born with a sibling who has developed jaundice previously, there is a greater risk of the newborn developing it as well. Premature babies are most at risk, since their livers have not fully developed.

Warning Signs

Besides jaundice, some other warning signs occur before the onset of kernicterus. A fussy baby who will not eat or sleep along with yellowing of the skin is at high risk of kernicterus. Babies who do not have at least four wet diapers in 24 hours are also at risk. Additionally, a baby who does not suckle well or refuses the bottle may be warning signs of kernicterus.

Treatment

Phototherapy treatment is used to lower the levels of bilirubin in babies. A blue light is placed over the baby to inactivate the bilirubin. The treatment does not hurt the baby, and it can be done in the doctor's office or at home. You can ask for a bilirubin test when you go home with your baby.

Kernicterus is a complication of infant jaundice. It occurs when bilirubin, which causes yellow pigmentation of the skin, starts to affect brain cells. There's a certain level of toxicity to bilirubin, and when infant jaundice is fairly severe, the bilirubin within the red blood cells can eventually enter the brain. If left untreated, your child may develop kernicterus, which is essentially a form of brain damage that can lead to other health-related issues including hearing impairment, cerebral palsy and cognitive difficulties.

Sepsis

One potential cause of kernicterus is sepsis, which is an infection of the blood. When your child's blood is infected with bacteria, it not only causes an inflammatory response within the body, but also an increase in the level of bilirubin within the bloodstream. As the amount of bilirubin rises, your child's brain becomes more and more vulnerable to its effects, making him more susceptible to kernicterus.

Liver Malfunction

It is also possible that a liver malfunction may be causing a rise in bilirubin, which can eventually lead to kernicterus. Since your child's liver is responsible for filtering bilirubin from his bloodstream, any malfunction or abnormality within this organ could decrease the vital process of filtration. This increases the concentration of bilirubin in the blood, elevating the chances of neurological damage to the brain.

Blood Disorder

Sometimes kernicterus is associated with a blood disorder. In this situation, the red blood cells, which are directly responsible for bilirubin, are atypical and could be producing more bilirubin than the liver can handle. This results in higher concentrations of the substance in the blood, increasing toxicity that can damage the brain.

Blood Type

Kernicterus can also be a result of your child's blood type. If your child has a different blood type from your own, there's an increased potential that you've passed an antibody to your child that actually causes the red blood cells to break down at a faster rate than normal, increasing the concentration of bilirubin in the bloodstream. And since your infant's liver is immature, it may not be able to effectively handle the filtration of bilirubin from the blood.

Malnutrition

When your child suffers from malnutrition, it can actually prompt the break down of red blood cells, increasing the level of bilirubin in the blood. And much like other causes of the condition, your child's liver may not be able to manage the increase in bilirubin.

Premature Birth

With kernicterus, premature birth can also be a contributing factor. This is largely due to the development of the liver, since "preemie's" organs are even more immature than full-term births, and she may not be able to filter the bilirubin from the blood as effectively as other infants.

Kernicterus is a potentially deadly disease that strikes newborns and can lead to death or permanent impairment. With proper medical intervention, the condition is preventable. The first step in preventing kernicterus is to understand what it is and how it affects your baby.

Understanding the Cause of Kernicterus

Kernicterus is a disease that affects babies after they are born. In this condition, excessive amounts of bilirubin build up in the blood stream and cause brain damage. Approximately 60 percent of newborns in the United States develop jaundice (which is easily identified with yellowing of the skin, yellowing of the sclera of the eyes and blood tests). Prolonged exposed to bilirubin severely damages the brain and can result in death or lifelong illnesses like cerebral palsy, problems with vision, hearing difficulties and mental retardation. This is a very serious medical condition, but the good news is that it can easily be prevented with proper medical care. Before your baby develops kernicterus, there will be signs of jaundice. When jaundice is left untreated, that is when kernicterus begins to develop. The key to prevention is early diagnosis and quick treatment to control the level of bilirubin.

Prevention

Treating jaundice and removing the dangerous bilirubin is the way to prevent kernicterus. Jaundice treatments like phototherapy (placing the baby under a special light) is quite effective in reversing the condition. The light introduces a blue color that helps to change the bilirubin into a water-soluble form that your baby's body can more readily eliminate. If your baby has reached high or dangerous bilirubin levels, there are more aggressive treatments like an exchange transfusion. This procedure rapidly removes the toxic substance from your baby's bloodstream. If your baby is exhibiting signs of acute kernicterus, brain damage is already occurring. Symptoms include high-pitched cry, arching of the back, fever, decreased appetite and abnormal tone. Immediate emergency treatment is crucial to prevent further damage and to reverse some of what has already been done. Treatment in this case usually involves triple-bank phototherapy treatment with the lights being placed as closely to the baby as possible. Do not allow your doctor to wait for bilirubin results to come back before beginning treatment--time is essential!

Conclusion

If your baby is already exhibiting symptoms, it is not too late to treat. Some damage may be reversible and the sooner the bilirubin levels are reduced, the less damage will be done to your baby's brain. The key to preventing kernicterus is to quickly treat any jaundice in your baby. Reducing bilirubin levels to the normal range will prevent kernicterus from developing. If you suspect that your baby is exhibiting any signs or symptoms, seek immediate medical attention. Never forget that you are your baby's advocate--if your baby is jaundiced, demand immediate treatment even before the bilirubin levels come back from the lab.

Any woman who has been pregnant can attest that breakouts are a natural part of pregnancy. And so is frustration over what medications are safe to use and what medications will harm the fetus. Even topical treatments can be damaging if they are absorbed by the skin and make their way to the growing fetus, so it's important to know what products are safe. Acne breakouts can be a frustrating experience for a woman already dealing with so much, but there are medications that are safe to use.

Ingredients

Most topical acne treatments have the same ingredients, though you will find some variance by brand. Most of them consist of benzoyl peroxide, hydrocortisone, salicylic acid, erythromycin, clindamycin, sodium sulfacetamide, tretinoin, adapalene and azelaic acid. The bulk of these have been found safe for pregnant women to use, but there are always cautions and warnings on any medication, whether over-the-counter or prescription. You'll want to check the ingredients label carefully on the topical medication you choose to use, because each chemical has different cautions regarding its use during pregnancy.

Sodium Sulfacetamide

Studies have found that sodium sulfacetamide is safe, for topical use only, during the early stages of pregnancy, generally the first two trimesters. However, use should be discontinued during the third trimester due to potential harm to the fetus. This drug has been found to lead to newborn toxicity, which can result in jaundice, anemia and kernicterus.

Tretinoin

Topical acne medications that contain tretinoin should be avoided completely during pregnancy. If you're already using a cream with tretinoin when you become pregnant, discontinue use immediately. While many drugs are safe early on and only become toxic later, this one has been shown to increase the incidence of birth defects when used during the first trimester.

Others

Other popular ingredients in topical acne medications include hydrocortisone, adapalene, azelaic acid and salicylic acid. Of these drugs, current studies have not been sufficient to determine their safety or risk during pregnancy. It is yet unknown how damaging, and in what manner, these could be to the fetus.

Doctor

The best thing to do with any medication that you are considering taking while pregnant is to speak to your doctor about it. Your doctor should be aware of current research and how it affects you and your growing fetus. Your own situation may be different from the normal condition, or there may be extra reasons in your particular case to be especially careful. It's never recommended for pregnant women to take any medication, whether it's prescription, over-the-counter or a topical agent without consulting her doctor for the risks and benefits to her particular situation.

Jaundice is a yellowish staining of the skin and eyes that can appear in newborns and adults. Adults develop this condition because of a disorder involving the liver, and jaundice is usually a symptom of another condition. In infants, this condition is caused because of a chemical called bilirubin, which builds up in a baby's blood. Everyone's blood contains bilirubin, and it is naturally removed by the liver. A pregnant woman removes the bilirubin from the fetus's liver, but it can take a few days for a baby to develop this function.

Medication

Zinc protoporphyrin IX (ZnPP) is a drug that has demonstrated the ability to fight off neonatal jaundice by inhibiting heme oxygenase (HO), which blocks the breakdown of red blood cells. Because this is a temporary condition that lasts for several days, it is important to combat jaundice with an effective chemopreventive agent.

Phototherapy

Medical professionals might place your baby under special lights that are designed to lower the bilirubin level in the body, preventing jaundice. Your baby's blood and skin absorb the light waves during phototherapy and change bilirubin into other products, which can easily pass through the system. The only side effect of phototherapy is that it loosens the bowel system, but that goes away when treatment is complete. This treatment is done in a hospital or clinic.

Screening

One of the safest and effective methods of preventing the onset of neonatal jaundice is to incorporate a simple screening method. This screening method is designed to measure the carbon monoxide production in the body by using a breath test. This test is able to identify high levels of bilirubin before it reaches a toxic level and causes jaundice. In extreme cases, jaundice can lead to brain seizures and brain damage.

Jaundice in Adults

To prevent jaundice in adults, understand how this condition is caused. Disorders that cause jaundice include alcoholic cirrhosis, viral hepatitis, cancer of the pancreas, biliary stricture, drug-induced cholestasis, hemolytic anemia and autoimmune hepatitis. By eating a healthy diet that is high in fruits and vegetables and exercising, you can lower your risk of developing many of these disorders. It's essential to avoid alcohol abuse, smoking, and intravenous drug use. The best way for adults to prevent jaundice is to live a healthy and active lifestyle.

Jaundice is a liver problem that can lead to harsher diseases like Hepatitis B virus and the use of bili lights. When the skin and eyes become yellow it is important to contact a doctor immediately. Jaundice occurs when there is an excess of bilirubin circulating through the blood stream. The bilirubins dissolve into the top layer of fat under the skin, causing it to turn yellow. The bilirubins flow into the blood after there is damage done to the liver. Jaundice is very common among newborn babies and can occur in adults as well.

Instructions

1

Place newborn babies under a light for phototherapy. The light will change the shape and function of bilirubin molecules and make the skin return to normal color.

2

Attach newborn babies to an IV to add immunoglobulin antibodies to the bloodstream.

3

Go to the doctor for a blood transfusion. In extreme cases a doctor will perform a blood transfusion to remove harmful cells and antibodies from the blood to cure jaundice.

4

Remove tumors or gall stones that put pressure on the liver. Common causes for adults with jaundice is damage from the pressure on the liver.

5

Receive a liver transplant. If the liver is severely damaged, a transplant may be necessary, but this is the absolute last resort.

Gilbert's Syndrome, pronounced "jeelbear," is a genetic condition. It affects the way the liver processes bilirubin, a natural waste resulting from the breakdown of hemoglobin in red blood cells. The syndrome causes jaundice but is normally benign. This article will help you recognize the common symptoms and get a diagnosis for this condition that affects 5% of the population. Read on to learn more.

Instructions

1

Watch for mild jaundice, a yellowing of the skin and whites of the eyes. Episodes of jaundice will appear and recede throughout life because the liver cannot process the yellow-colored bilirubin fast enough.

2

Notice any fatigue or abdominal pain. Doctors do not yet know how abdominal pain is linked to Gilbert's Syndrome.

3

Expect symptoms to appear more prominently during times of stress, exertion, infection and illness, fasting and after drinking alcohol.

4

Find this genetic syndrome occurring more frequently in the same family and usually affecting more males than females. Symptoms usually present after puberty.

5

Get an indirect bilirubin blood test to check for liver problems. Four hours prior to the test, fast and stop taking medication and caffeine to avoid interfering with the test results. Doctors can usually diagnosis Gilbert's Syndrome easily with this test and will rarely need to take a liver biopsy.

Seizure Symptoms

Seizures in a baby less than 28 days old can have many different causes, but several similarities exist. Seizures can often be short in duration and subtle in their appearance, making it difficult to tell if a real seizure is taking place. Repetitive facial movements such as sucking or chewing are possible. Rhythmic jerking movements, stiffening or tightening of muscles and quick, single jerks are all possible indicators. Seizure symptoms can also include odd bicycling movements, prolonged staring and a failure to breathe for a short period of time.

Genetic Causes

In families with a history of seizures, a baby may begin having seizures at 2 to 8 days old. Sometimes known as the fifth-day fits, they are a form of epilepsy that is caused by a genetic mutation. It is inherited from the baby's father or mother. Seizures may last from one to two minutes and may be as frequent as 20 or 30 times a day. Typically, the baby grows out of the seizures by 16 months old, though the child will have a higher chance of developing epilepsy later in life. Congenital brain abnormalities can also cause seizures.

Symptomatic Seizures

Seizures that are not caused by genetics are usually due to external factors. A lack of oxygen before or during birth, infection after birth, a stroke before or after birth, blood clots or bleeding in the brain, blood sugar or electrolyte imbalances, metabolic problems and drug withdrawal for babies born to chemically dependent mothers are all possible causes. In addition, babies with low birth weights are more at risk for seizures. The cause of some benign seizures is unknown, but may be related to a zinc deficiency or a virus.

Diagnosis

Many movements that take place during a seizure also take place in normal, healthy infants. If a seizure is suspected, various non-invasive laboratory tests can be conducted to determine the cause. If a parent can end the motion or behavior by changing the position of a baby's limbs, it is not a seizure. Diagnosis will also take into account family history.

Hyperbilirubinemia occurs when there is build-up of a naturally occurring substance called bilirubin in the blood. The normal breakdown of red blood cells produces bilirubin. When infants are not able to get rid of the breakdown of bilirubin and it builds up in the blood, tissues, and fluids it is called hyperbilirubinemia. Hyperbilirubinemia is commonly referred to as jaundice in the newborn. Phototherapy is the most common treatment.

Phototherapy Treatment

According to C.S. Mott Children's Hospital, photherapy has been used for over 30 years in the treatment of hyperbilirubinemia or jaundice in the newborn.

Phototherapy is a light treatment in which lights are used to eliminate bilirubin in the newborn. Your infant's skin and blood will absorb the lights from the phototherapy treatment. This absorption will break down the build-up of bilirubin and allow it to pass through your baby's system.

Conventional phototherapy consists of rows of ultraviolet lights that are suspended over your infant. There is also a spotlight that can be suspended at a distance to form light over your baby. The phototherapy lights would shine directly down on your infant. The infant would typically only have on a diaper for maximum exposure to the light and would be in either a radiant warmer, a type of open bed in the Neonatal Unit or they are placed in an isolate, which is a enclosed plastic incubator. Both are heated to keep your infant warm during treatment. Your baby would be wearing soft eye patches to protect his eyes from the ultraviolet lights.

Depending on the level of bilirubin in your baby's blood, will depend on the number of lighting sources used to help bring down his levels as quickly as possible. Single lighting, double phototherapy or triple phototherapy can all be used to treat the hyperbilirubinemia.

Your physician can also prescribe the use of a biliblanket. This is a fiber optic blanket that is wrapped around your infant's body. The biliblanket provides a high level of therapeutic light to treat hyperbilirubinemia. The strength of the biliblanket is comparable to the amount of light you would get while in the shade on a sunny day. The biliblanket is a safer option due to the fact that it filters out harmful ultraviolet and infrared lights. This is also a convenient form of phototherapy because your baby can be clothed, held and fed while the biliblanket is turned on. Your baby can also in some cases be discharged from the hospital on a biliblanket instead of having to stay additional days in the hospital under conventional phototherapy.

The length of time your baby will need phototherapy treatment will depend on the levels of bilirubin in his blood. Blood samples will be taken to test the levels and when normal levels of bilirubin are present in the blood, the phototherapy can be discontinued.

Considerations

During phototherapy treatment for hyperbilirubinemia, it is important that your baby is feeding on a regular basis. Breastfeeding is still encouraged during treatment and if the baby is not receiving adequate fluids during feeding an intravenous line may be placed to ward off dehydration from the lights.

An unborn baby has extra red blood cells to carry the oxygen it receives from its mother through the placenta. After birth, the newborn is breathing oxygen and the extra blood cells are no longer needed. The infant's liver destroys the red blood cells. A by-product of that process is bilirubin. Bilirubin is eliminated, or metabolized, through stools and the skin, which causes yellow coloring, or jaundice. Mild jaundice may protect newborns from free radicals, according to the National Academy of Sciences.

History

Due to a high incidence of Rh hemolytic disease in the 1950s, treatment of neonatal jaundice was aggressive. Such treatment continued through the 1970s although the development of Rhogam, a vaccine for mothers with an Rh negative blood type, dramatically reduced the incidence of serious blood incompatibilities. Phototherapy treatment was developed when a nursery nurse noticed that babies placed near the window were less yellow than other babies.

Significance

Neonatal jaundice, also called kernicterus, occurs within the first 24 hours after birth, or that is characterized by extremely high (over 30mg/dL) total serum bilirubin (TBS), is considered high risk. Infants in that category are at risk of brain damage, liver disease, and if untreated, death. Blood transfusions may be necessary to save those babies. Only one in 10,000 infants are high risk.

Types

In a normal term infant, levels of bilirubin peak at less than 12 mg/dL in the first three to five days of life. TBS levels below 20 mg/dL are considered low risk. Moderately higher than normal bilirubin levels, called hyperbilirubinemia, are associated with mothers who have O positive blood types, and may have less serious ABO incompatibilities. Premature infants, who have immature livers that cannot adequately process the destruction of extra red blood cells, are also at risk for hyperbilirubinemia.

Identification

The rate of rise of total serum bilirubin in the first 24 to 48 hours is a predictor of serious jaundice, so babies that look yellow right after birth should receive medical attention. Physiological (normal) newborn jaundice occurs on the third to fourth day of life, and is noticeable first in the face and the whites of the eyes. Jaundice that spreads below the belly button to the hips and legs may be indicative of higher bilirubin levels. A jaundiced newborn who becomes lethargic and does not feed well should be evaluated by healthcare professionals.

Prevention/Solution

Unlike commercial infant formulas, breastmilk binds with bilirubin and carries it out through the digestive tract, so mothers should begin nursing early and breastfeed as often as possible to prevent jaundice.
The skin is an organ of elimination. Sunlight, either direct or indirect through a window, helps newborn skin eliminate jaundice more quickly. Expose as much naked skin as possible to the light. Use common sense to avoid extremes of temperature or sunburn.
Artificial light is effective if it is close enough. The baby's eyes must be shaded or covered to prevent harm. Home health product suppliers can provide a "biliblanket" that glows, for wrapping jaundiced infants.
Elimination of bilirubin can also be helped by feeding extra fluids, especially if a baby is being treated by phototherapy, or artificial lights, in the hospital or at home.

Brain damage is a serious occurrence. Injury to the brain can result in a disruption in normal brain activity. Each lobe of the brain is responsible for different functions and is susceptible to being damaged.

Frontal Lobe

Damage to the frontal lobe of the brain can result in problems with movement, thinking and attention. Other symptoms include changes in personality, mood and social behavior.

Parietal Lobe

Injury to the parietal lobe leads to issues with words and reading, such as the inability to name an object or locate a word to use for writing.

Occipital Lobe

When the occipital lobe is damaged, patients will experience hallucinations, visual illusions, word blindness, and problems with their visual fields.

Temporal Lobe

Temporal lobe injury patients exhibit short-term memory loss, issues with long-term memory and selective attention, and difficulties understanding spoken words.

Cerebellum

As the cerebellum is the control center for movement, damage to the cerebellum results in being unable to walk, coordinate fine movements, and reach out and grab items. In additions, patients may also have tremors and dizziness.

Your flower garden is an enjoyable hobby and few things are more frustrating than having those flowers destroyed overnight by rampaging wildlife. It's a common misconception that moth balls placed in a garden will keep these animals away. In fact, it's illegal to use moth balls in this manner. Not only are moth balls highly toxic, they are also useless against outdoor pests.

Effects on Plants

A Cornell University study found that paradichlorobenzene is toxic to some plants. The study reported that the chemical causes damage to roots, seeds and seedlings. Trees also showed serious injuries after being exposed to the chemical.

Effects on People and Pets

Moth balls may look like candy. If eaten, however, the insecticide poses serious health problems including brain damage. Young children can develop a devastating breakdown of their red blood cells within hours of being exposed to naphthalene. This condition can result in jaundice and kernicterus, which is a form of neurological damage connected with profound disability. Moth balls can also cause liver failure in dogs and cats. Animals showing signs of moth ball exposure, such as seizures, vomiting, and an odor of mothballs around the mouth should be taken to the veterinarian immediately.

Alternative Wildlife Deterrents

Use hot peppers to make your own effective wildlife deterrent.

North Dakota State University horticulturist Ron Howard states that moth balls are ineffective against nuisance wildlife such as rabbits or mice. Instead, consider using commercially-available wildlife repellents or make your own. Deter wildlife from helping themselves to your marigolds by placing three hot peppers into a blender with enough water to make a liquid. Blend these two ingredients together and pour the resulting mixture through a strainer or cheesecloth. Add two tablespoons of vegetable oil or olive oil, a teaspoon of non-toxic white glue, and a squirt of liquid detergent. Mix well and add one part of this concoction to ten parts of water in a large spray bottle. Spray your plants. The wildlife might take one bite, but then they'll opt for less spicy fare. Re-apply this mixture after a heavy rain.

Exclusion fencing is also an effective means of keeping unwanted wildlife out of your flower garden. Twenty-four-inch-high wire mesh fencing or hardware cloth keeps out many animals. Encircle your flower beds with this fencing in the spring when plants are most vulnerable.

Kernicterus is a type of brain damage caused by infant jaundice. It normally occurs in small, premature babies whose liver has not fully developed. Infant jaundice can lead to high levels of bilirubin circulating in the blood, which in turn leads to the development of kernicterus. If not treated quickly, kernicterus can lead to brain damage in the infant. Even with its dangerous effects, the condition is preventable.

Instructions

1

Give babies regular feedings. Regular feeding, especially for premature infants, is important for the prevention of jaundice, which leads to kernicterus. It's recommended that babies that are breast feeding receive 12 daily feedings for the first few days of life. Formula-fed infants should be fed this frequently during the first several weeks of life.

2

Test babies for possible liver problems. High bilirubin levels normally occur by the fifth day of life. If the baby is premature, ensure testing is done to prevent kernicterus. A nomogram measures the baby's bilirubin levels and plots it on paper. This is a good way to predict the possibility of future high levels in bilirubin.

3

Treat high bilirubin levels with phototherapy. The most common form of preventing kernicterus when bilirubin levels get too high is through phototherapy. The baby is placed under a blue light. The light is harmless to the baby, but it turns harmful bilirubin into an innocuous, water-soluble form. The procedure is performed in a hospital, so time is of the essence when treating babies for high bilirubin levels before the onset of kernicterus.

4

Watch for warning signs. There are a number of physical cahnges that occur before the onset of kernicterus. Jaundice itself spreads from the head to the toes, but other warning signs exist. The baby may be fussy and refuse to breastfeed. The baby may be difficult to wake up, and bowel movements might be limited. If the baby does not have at least four dirty diapers a day, it may be a warning sign of kernicterus.

Jaundice is when your skin, the whites of the eyes and mucous membranes become tinted yellow, due to excessive bilirubin, a byproduct of old red blood cells. Everyday about 1 percent of a body's old red blood cells are replaced by new ones, and the liver processes the old ones. If the liver is overwhelmed, jaundice occurs.

Types

Jaundice that occurs in healthy newborns is physiologic jaundice and is quite common and seen even more often in premature infants. Pathologic jaundice is when there is a health risk with the jaundice, while Gilbert syndrome is a mild, inherited condition that causes jaundice.

Newborns

While common, high bilirubin levels can be dangerous to newborns and lead to kernicterus which can cause mental retardation, hearing loss and other serious problems. Treatment is usually phototherapy or in severe cases blood transfusion.

Levels

Normal bilirubin totals in the bloodstream are in the range of .20mg/dl to 1.50mg/dl. If direct bilirubin testing is done, the average is .00 to .03mg/dl. Levels beyond this along with serious symptoms, would indicate a dangerous jaundice level.

Identification

Jaundice indicates a problem and treatment depends on the cause of the high bilirubin levels behind the jaundice. Some possible causes include liver disease or damage, a type of anemia, a liver blockage, cirrhosis, hepatitis, toxic drug reaction or chronic alcoholism.

Considerations

Typically, to diagnose any cause of jaundice, other than common newborn jaundice, a physician will take a complete medical history, do a thorough medical exam and do other testing such as liver function test, complete blood count, urine and stool tests, and an abdominal ultrasound.

Kernicterus is a form of brain damage that results when bilirubin enters the brain tissue. This occurs in newborns because the blood-brain barrier is not yet completely formed.

Jaundice

Slight jaundice is normal in newborns but severe jaundice can indicate that bilirubin is building to dangerous levels.

Extreme Lethargy

Babies normally spend a good deal of time sleeping but a lethargic baby will have difficulty waking up or staying awake. Lethargic babies may not respond to touching or have poor startle reflexes.

Crying

Babies with kernicterus may have an unusual cry that has a very high pitch.

Muscle Tone

A baby with kernicterus may have floppy or weak limbs. They may also arch their backs or heads in an abnormal manner.

Brain Damage

Permanent brain damage due to kernicterus may also cause learning problems or other developmental delays. Other symptoms of brain damage include uncoordinated movements, hearing loss and difficulty moving the eyes.

Hyperbilirubinemia is the diagnosis given when the body has too much bilirubin in the blood and other tissues of the body. Bilirubin is formed in the body when red blood cells break down. Depending on what is causing the hyperbilirubinemia, it may appear at birth or at any time in a person's life. Yellowing of the skin, or jaundice, is a common sign of hyperbilirubinemia.

Causes in Infants

Newborns can have hyperbilirubinemia simply because their bodies are unable to excrete the bilirubin fast enough during their first few days of life. A baby may also get what is called breast milk jaundice. This is when an infant gets hyperbilirubinemia after its first week of life. This is usually a result of the infant being dehydrated or having a low calorie intake. Rh disease can also cause hyperbilirubinemia, as can bleeding and having too many red blood cells. A baby that has inadequate liver function due to a health condition or an infection may also develop hyperbilirubinemia. Infants that are born to diabetic mothers are also more likely to develop the condition.

Causes in Adults

While hyperbilirubinemia is more common in babies, adults can develop the condition for any number of reasons. These include having infections such as hepatitis A, B, and C, autoimmune disorders, chronically using alcohol, having liver and pancreas problems/disorders and more.

Diagnosis/Treatment

Red blood cell counts can help doctors diagnose hyperbilirubinemia, as well as blood typing and testing for Rh incompatibility, which is known as the Coomb's Test. Treatment can include phototherapy which involves exposing the skin to special blue spectrum lights or placing a fiberoptic blanket beneath the individual. The lights and blanket may be used separately or in combination with each other. If the condition is caused by an underlying condition it will be treated. Infants who have breast milk jaundice will need to cease from breastfeeding and take formula for approximately two days so the baby's bilirubin level can lower.

Concerns

When large amounts of bilirubin circulate in the body they can go the brain. This can lead to a condition called kernicterus and it can cause seizures and brain damage. For this reason, parents should carefully monitor their newborn's skin, particularly after they take their new baby home, and look for yellowing. Yellowing of the skin is the common symptom of hyperbilirubinemia. It generally begins on the face and then moves downward on the body. Babies may also seem lethargic and have trouble feeding.

Prevention

There is no way to completely prevent hyperbilirubinemia. However, recognizing it and getting treatment as soon as possible can go far in keeping the condition from becoming dangerous. Women who have their babies at home should have their baby's checked by a pediatrician the day of birth.

According to the Mayo Clinic, jaundice is represented by a yellow tone in the baby's skin. The condition is common in newborns, particularly those who were born prematurely. In most cases, jaundice is not dangerous.

Condition

Jaundice is caused when the liver is not fully developed or functioning. This underdevelopment prevents the liver from processing excess bilirubin in the bloodstream, causing a yellow coloring of the skin and eyes. The symptoms of jaundice usually become first apparent in a baby's face.

Risks

If jaundice is severe and left untreated, brain damage can result as excess bilirubin is toxic to brain cells. However, complications from jaundice are rare.

Symptoms

Jaundice causes yellow coloring of the eyes and skin. It typically occurs during the first few days of life. Bilirubin levels in babies will reach their maximum three to five days after birth. The infant should be evaluated for jaundice during this time.

Treatment

Most babies with jaundice will benefit from light therapy. The special light changes the composition of the bilirubin to assist the body in breaking it down. For more severe cases, immunoglobulin or blood transfusions may be necessary.

Home Remedies

Increasing feedings can be another treatment option for jaundice because they can increase bowel movements and therefore the excretion of bilirubin in the stool. This should only be done under the supervision of a physician.

The gallbladder is a nonessential digestive organ that serves as a storage pouch for excess bile. When bile hardens and crystallizes, gallstones may form. These stones may cause painful gallbladder attacks and liver complications that lead to jaundice. Jaundice is a condition characterized by a dangerous accumulation of bile in the bloodstream.

Symptoms

Gallstones cause symptoms such as upper right abdominal pain, back pain and shoulder pain. When gallstones get stuck in the common bile duct they may cause jaundice.

Complications

Gallstones may lead to serious complications such as jaundice. Symptoms of jaundice include yellowing of the skin and eyes.

Causes

Jaundice may occur when a gallstone blocks the common bile duct. The common bile duct serves as passageway from the gallbladder and liver to the small intestine. When this occurs, the bile is unable to travel from the liver to the small intestine and this causes bile to build up in the blood stream, resulting in jaundice.

Identification

Jaundice may initially be identified by a noticeable yellowing of the skin and eyes. This discoloration occurs as bile accumulates in the blood. One substance contained in the bile is bilirubin, which causes the yellowing. Jaundice may be diagnosed with blood tests, liver function tests, liver biopsy and abdominal ultrasounds.

Treatement for Jaundice

There is no treatment for jaundice in adults except to remove the gallstone causing the blockage.

Silvadene (generic name: Silver Sulfadiazine) is a topical antibiotic and sulfonamide used to treat second- and third-degree burns, skin ulcers and bacterial skin infections. The medication also is employed to prevent the manifestation of bacterial or fungal infections from affecting existing wounds. Silvadene is available by prescription only and is often used in conjunction with other medications to treat burns most effectively.

Features

Silvadene works within cell membranes and walls to kill bacteria in open wounds. It helps prevent contamination and bacterial growth from reaching other skin or infiltrating the blood, which can lead to sepsis. Sepsis is a severe blood infection that the body develops in reaction to microbes such as bacteria. Silvadene possesses widespread antimicrobial activity giving it the ability to kill various types of bacteria and fight off yeast.

Function

Silvadene is administered topically to the skin in a layer that is approximately one-sixteenth of an inch thick. The skin wound should be properly cleansed before the medication is applied. Doctors usually direct their patients to apply the cream twice daily, to ensure that the irritated area is always covered. The cream needs to be put on the skin regularly to be most effective. Individuals using Silvadene for burns are advised to use it persistently until the burn site has sufficiently healed or are set to undergo skin grafting procedures.

Dosaging

Every gram (equivalent to 28.350 of an ounce) of Silvadene Cream (1%) holds 10 mg of the micronized antimicrobial agent silver sulfadiazine. The remaining elements include: isopropyl myristate, polyoxyl stearate, propylene glycol, sorbitan monooleate, stearyl alcohol, water and white petrolatum. The prescribed dosage is centered on a person's specific medical condition and their reaction to the treatment. Silvadene comes in jars that contain the measured quantity of 50g, 400, and 1000g; in addition to tubes holding 20g and 85g.

Side Effects & Adverse Drug Reactions

While infrequent, Silvadene can cause side effects such as burning sensations, rash and skin discoloration. Even though Silvadene is used in conjunction with other medications to treat burns and skin irritations, topical enzyme preparations that contain the ingredients such as collagenase, papain, and sutilains can have an adverse effect on the medication. Additionally, when Silvadene is used alongside particular drugs, it can alter their effectiveness and potency. People who are allergic to sulfa drugs (or drugs containing sulfa) including: oral antidiabetics, Bactrim, Daranide, Cimetidine, Collagenase, Lasix, Neptazane, and diuretics (water pills), are advised against using Silvadene.

Warning

People who have medical conditions such as kidney and liver disease, porphyia, blood problems and a deficiency of the G6PD enzyme should use Silvadene with extreme caution as it has the potential to aggravate these conditions. Women, who are pregnant, nursing or plan on becoming pregnant, should consult their doctor prior to starting on a Silvadene regimen because sulfa medications have the potential to pass into breast milk when taken orally and applied topically.

An elevated bilirubin level marks a problem with the liver, the organ that cleanses the body of toxins. A newborn's liver may not be able to process all the old red blood cells (bilirubin), and a yellow tinge to the skin develops. Exposing the baby to natural sunlight was historically what was done to improve the condition and is still recommended by some if the jaundice is mild. Current treatments include phototherapy, drug therapy and blood transfusion.

Instructions

1

Consider usingg phototherapy, the least invasive procedure. This treatment is administered by a Bili-blanket, a device prescribed by a neonatologist or pediatrician. The equipment consists of a fiber-optic blanket, cabling and a box that serves as a light source. The blanket is placed on the baby, who is preferably clad only in a diaper, so that as much of the skin is exposed to the blanket's surface area as possible. Avoid covering the baby's eyes with the pad. The blanket can be worn under clothing if necessary.

2

Consider treating the baby with intravenous immunoglobulin. Immunoglobulins are produced by the white blood cells to fight off infection and auto-immune deficiencies and have been found effective in the treatment of hyperbilirubinemia. This procedure will be done in a clinical setting under a doctor's direction.

3

Investigate drugs such as phenobarbital, cholestyramine, agar and clofibrate. Phenobarbital is the most widely used drug therapy but is not recommended if the jaundice is acute due to the slow-acting nature of the drug. Cholestyramine and agar work together and enable bilirubin to attach to bile acids, which are then excreted. Clofibrate is a very promising treatment due to its low incidence of side effects and, when combined with phototherapy, lessens the symptoms of jaundice quicker than phototherapy alone.

4

Investigate the option of blood transfusion, which may be necessary if the infant's jaundice is severe. This procedure will be done in a hospital setting. The baby's blood will be completely transfused (exchanged) with a matching type of blood.

Hyperbilirubinemia is caused when too much bilirubin, a substance formed when red blood cells break down, is found in the blood. Babies are not able to get rid of the bilirubin, so it builds up in blood and tissues. Jaundice often accompanies hyperbilirubinemia. The pigment of bilirubin causes the baby's skin and the whites of the eyes to become yellow, resulting in jaundice. Jaundice can happen at birth or later, depending on the cause of the hyperbilirubinemia. Cornell University states that 60 percent of full-term babies and 80 percent of premature babies will experience jaundice, and that babies born to diabetic mothers or those with Rh disease are more likely to have hyperbilirubinemia and jaundice.

Causes

A baby's own liver has to take over processing bilirubin for elimination through stool after birth. Sometimes this takes a little while, so the infant has hyperbilirubinemia until the body is able to handle removing it. This form of the condition, called physiological jaundice, usually clears up within two weeks.

Breast milk jaundice is caused by a substance present in the milk that increases reuse of bilirubin by the intestines. Babies with this type of jaundice usually show signs after day 7 of breastfeeding, with the condition clearing completely after a month or so.

Underlying Medical Conditions

Underlying medical conditions can cause hyperbilirubinemia in some infants. Some conditions that can cause the problem are congenital spherocytic anemia, elliptocytosis, blood type incompatibilities, injury during birth, infection and transfusion. Alpha-1 antitrypsin deficiency, some medications, congenital hypothyroidism, rubella and syphilis among other congenital conditions. Hypoxia and neonatal hepatitis are other conditions that can cause jaundice and hyperbilirubinemia.

Considerations

Most cases of hyperbilirubinemia cause no concern, but if high enough concentrations of bilirubin accumulate in the tissues of the brain, seizures may occur. This can lead to brain damage or a condition called kernicterus.

Symptoms

The most common symptoms associated with hyperbilirubinemia are yellowing of the skin that begins on the face and moves downward over the body, lethargy and poor feeding habits.

Risk Factors

Healthy, full-term babies who are more likely to develop hyperbilirubinemia and newborn jaundice have a sibling who needed phototherapy for jaundice, have high bilirubin levels, are only breastfeed and may be overweight, have a red blood cell disease or blood group incompatibility, significant bruising, are of Asian descent or have jaundice during the first 24 hours of life.

Treatment

Treatment for hyperbilirubinemia and jaundice includes phototherapy, in which the baby is exposed to special blue spectrum lights to decrease levels of bilirubin. Sometimes, a fiber optic blanket is placed under the baby as an added phototherapy technique. Exchange transfusion, in which the baby's blood is replaced with new, undamaged blood, is used. Stopping breastfeeding is required if breastfeeding jaundice is to blame.