Jaundice in Newborns

What is bilirubin made from?

the breakdown of RBCs

TRUE or FALSE: newborns produce 1/2x as much bilirubin as adults.

false; they produce 2x as much

When do bilirubin levels typically decline to adult levels?

10-14 days through excretion in stool

What is physiologic jaundice?

more common + mild and typically goes away on its own

When does physiologic jaundice occur?

2-4 days of life

When does pathologic jaundice occur?

within first 24hrs of life

TRUE or FALSE: pathologic jaundice is always abnormal.

true

What are some causes of pathologic jaundice?

• Rh incompatibility

• ABO incompatibility

• COOMBS positive

How is pathologic jaundice caused by Rh incompatibility?

mixing of blood between Rh- mom and Rh+ baby

How does ABO incompatibility cause jaundice?

mom’s O antibodies attack A or B baby’s RBCs and cause lysis

What is COOMBS positive?

antibodies detected in baby from AB/O mixing

What should you do if a baby is COOMBS positive?

check initial bilirubin + start on phototherapy

What are the bilirubin levels with bilirubin encephalopathy?

25-27

When does bilirubin encephalopathy occur?

preterm or compromised infants

What are some risks of bilirubin encephalopathy?

• brain damage

• seizures

• cerebral palsy

• all due to staining of the brain from bilirubin

What is the primary symptom of bilirubin encephalopathy?

a lethargic, high-pitched cry

How does phototherapy help hyperbilirubinemia?

UV light causes decomposition of bilirubin

Which two parts of the body should be protected during phototherapy?

eyes + genitalia

What should you monitor in an infant on phototherapy?

temperature + fluid intake

Why should you not put lotion on a newborn on phototherapy?

it can burn their skin