Bilirubin Level in Newborn Baby: Physiological vs Pathological Jaundice, Range and More
Medically Reviewed By
Dr Divya Rohra
Written By Prekshi Garg
on Feb 28, 2022
Last Edit Made By Prekshi Garg
on Mar 18, 2024
Neonatal hyperbilirubinemia or neonatal jaundice is a cause of concern for the first seven days in a baby. It’s development is observed in around 8 - 11% of neonates. Neonatal hyperbilirubinemia denotes a high level of bilirubin that can be toxic for the development of the central nervous system. About 60% of the cases of high bilirubin levels in the first seven days in babies are benign and get okay without any intervention. About 5 - 10% of cases of hyperbilirubinemia in babies require the use of phototherapy for its treatment. This article explores neonatal jaundice, normal range of bilirubin in babies, and the difference between physiological and pathological jaundice.
Normal Range of Bilirubin in Newborn Babies
The normal range of bilirubin in newborn babies is approximately 0.3 mg/dl to 1.0 mg/dL within the first 24 hours of birth. The level of bilirubin which is referred to as critical for the baby and when phototherapy is given for treatment is:
- 25 - 48 hours old: total serum bilirubin level above 15 mg/dL
- 49 - 72 hours old: total serum bilirubin level above 18 mg/dL
- > 72 hours old: total serum bilirubin level above 20 mg/dL
Physiological Jaundice vs Pathological Jaundice
Physiological jaundice:
It is the most common type of neonatal hyperbilirubinemia without any serious consequences. The bilirubin in physiological jaundice is generally in unconjugated form and it’s levels in the serum are less than 15 mg/dL. Physiological jaundice appears 24 - 72 hours after the birth. The levels of bilirubin in this condition are at their peak on the 4th or 5th day after birth and finally disappear when the baby is 10 - 14 days old.
Pathological Jaundice:
When the bilirubin levels in a newborn baby exceed a level such that intervention is required is known as pathological jaundice. In this, the levels of serum bilirubin go beyond 5 mg/dL/day within 24 hours of birth.
Takeaway
Neonatal jaundice is an extremely common condition appearing in the first seven days of life. This requires careful monitoring of the baby for the first week. In mild cases, it gets treated on its own, and in severe cases, phototherapy can effectively treat jaundice. Now that you know well about neonatal hyperbilirubinemia, you can better monitor your baby in the first few days of their life.
Frequently Asked Questions (FAQs)
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How can I reduce the bilirubin level of my baby?
The bilirubin levels in the first few days of your baby’s life is a very critical parameter. In the case of hyperbilirubinemia, phototherapy, exchange transfusion, intravenous immunoglobulin, and enhanced nutrition can help in reducing the bilirubin levels.
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Can bilirubin level rise back after phototherapy?
Yes, the bilirubin levels can rise back after phototherapy in some rare cases. In such a situation, follow-up and other treatment options are also considered for the baby.
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Is phototherapy a safe treatment option for hyperbilirubinemia?
Yes, phototherapy is a very safe and effective treatment option for hyperbilirubinemia as it does not contain any rays that can harm your baby. The treatment is most effective when the maximum skin of the baby is exposed to the light.
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Is 19 mg/dL considered as a high bilirubin level in newborns?
When the total serum bilirubin level rises by more than 5 mg/dL/day or if the level is above 17 mg/dL during the first 24 hours after the birth, the baby is known to suffer from hyperbilirubinemia.