Newborn Bilirubin Check

A newborn bilirubin check is a 30-minute non-routine visit to assess your baby’s bilirubin levels. Bilirubin is a normal substance that results from the breakdown of red blood cells. Extremely high bilirubin levels can cause neurological damage. We screen, so that if levels are rising at an unusually fast rate, we can intervene with increased feeding and/or bilirubin lights to stabilize the bilirubin levels and prevent damage. 

 

Newborns are at risk for excess bilirubin levels for a number of reasons: their red blood cells break down faster than an adult’s, their liver is immature so they cannot clear bilirubin as well as an adult can, they clear bilirubin by pooping but they don’t have many poops until day 3 or so when the milk comes in, and some babies are genetically more at risk. 

 

A newborn bilirubin check is required when there is concern for high bilirubin based on physical exam, excess weight loss, lethargy, or at the midwife’s discretion. The midwife will examine your baby for jaundice (yellowing of the skin), weigh your baby, assess vital signs, and then poke your baby’s heel to collect blood to send to the lab. 

 

In cases where the bilirubin has crossed the threshold of safely being able to offer bilirubin lights at home, or if the bilirubin levels are increasing very quickly, the midwife might recommend a transfer of care to the hospital for access to more powerful bilirubin lights.