Beyond Phototherapy: Monitoring Serum Bilirubin Levels, Massaging Babies, and Using a Bilirubinometer

Jaundice also known as neonatal hyperbilirubinemia is as common today as it was half a century ago, only with newer advances being suggested left and right alongside the gold standards of treatment that already exist and that have helped modulate its existence within the clinical setting. In this review, we will be highlighting three evident examples from literature of helpful methods for the evaluation and management of neonatal hyperbilirubinemia beyond just the treatment of afflicted infants with phototherapy. This review will refer to two studies and one idea from another study all related to the levels of bilirubin. Namely, whether or not bilirubin levels can affect feeding and sucking, how massaging babies can help reduce bilirubin levels and increase stool frequency, and finally what a bilirubinometer can offer as a method of early detection. keywords Jaundice, hyperbilirubinemia, Patients. Introduction Jaundice is the clinical condition characterized by elevated levels of bilirubin in the blood, termed as 'hyperbilirubinemia'. It is manifested by yellowish discoloration of the skin, eyes, and sclera, particularly. As common as it is, no harm is ever really evident unless proven otherwise by rigorous evaluation and testing. In the first few days of life, the hemoglobin that was present in the fetal bloodstream begins to break down into fragments, each circulating to be filtered. These fragments are derived from the breakdown of red blood cells (RBCs) and end up forming none other than the yellowish-green material known as bilirubin, that usually accumulates in the neonatal period due to a lack of the enzyme that should conjugate it in order to allow it to be excreted further. In newborns, jaundice is labelled physiological when it appears in the first few days of life and disappears slowly with time, thereby highlighting how transient these cases are. On the other hand, it is deemed pathological when it appears on the first day of life with the serum total bilirubin rising to more than 12 mg/dL (in a fullterm infant); continuing to be present for more than 2 weeks. This is where extreme consideration by physicians is taken to exclude the probable causes of pathological jaundice characterized by further increased levels of conjugated bilirubin, such as gallbladder disorders (cholestasis), therefore ruling out potential causes such as infection, hemolysis, or enzymatic defects of the RBC surface