Jaundice

My morning nurse at Swedish walked in today and had the audacity to inform my parents and I that I had jaundice. Up to this point I had been told time and again that I was perfect. What gives?!

In case you don't know what jaundice is, here is an explanation... Bilirubin, a chemical formed during the normal breakdown of red blood cells, is usually removed from the blood by the liver. But newborns often produce more bilirubin than their immature livers can handle. As a result, the bilirubin builds up in the blood, causing the yellowish tinge and what is known as normal, or physiologic, newborn jaundice.

In physiologic jaundice, yellowing usually begins on the second or third day of life, peaks by the fifth day, and is substantially diminished by the time baby is a week or ten days old. It appears a bit later (about the third or fourth day) and lasts longer (often fourteen days or more) in premature babies because of their extremely immature livers. Jaundice is more likely to occur in babies who lose a lot of weight right after delivery, in babies who have diabetic mothers, and in babies who arrived via induced labor.

Mild to moderate physiologic jaundice usually requires no treatment. Usually a doctor will keep a baby with high physiologic jaundice in the hospital for a few extra days for observation and phototherapy treatment under fluorescent light, often called a bililight. Light alters bilirubin, making it easier for a baby's liver to get rid of it. During the treatment, babies are naked except for diapers, and their eyes are covered to protect them from the light. They are also given extra fluid to compensate for the increased water loss through the skin.

If the light therapy does not produce and improvement, then the jaundice is likely nonphysiologic and requires a greater degree of medical attention as nonphysologic jaundice can lead to brain damage if untreated. Obviously I'm pulling for good ol' normal jaundice.

The phlebotomist is due to arrive momentarily to take my first bilirubin test. I might as well come to terms with the fact that I'm going to be a veritable pincushion for the next two years or so. Woe is me.