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Ask a QuestionGuardian of a 4 m old boy4 months ago
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#asktheexpert Baby is having bilirubin level of 20 despite having good breast feeding .. Likely reasons and actions to be taken
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POOJA KOTHARIMom of a 8 yr 5 m old boy4 months agoA. A bilirubin level of 20 mg/dL in a baby is significantly high, especially after the first few days of life, and it requires immediate medical attention.
Possible Causes of High Bilirubin (20 mg/dL) Despite Good Breastfeeding:
Physiological Jaundice
Common in newborns, but usually mild and peaks at 3–5 days. Can still reach high levels if liver is slow to process bilirubin.
Breastfeeding Jaundice
Due to insufficient milk intake early on, leading to dehydration and less bilirubin excretion. Even if breastfeeding is now good, early days may have impacted it.
Breast Milk Jaundice
Caused by substances in breast milk that slow bilirubin breakdown. Typically appears after day 5 and can last for weeks.
Blood Group Incompatibility (ABO or Rh)
If mom and baby’s blood types are different, this can cause faster RBC breakdown.
G6PD Deficiency
A genetic condition causing rapid breakdown of red blood cells.
Infections or Liver Issues
Less common but possible, like sepsis or biliary atresia. What Needs to Be Done Now:
Immediate Pediatric Evaluation
A bilirubin of 20 is not safe to manage at home. Go to the hospital urgently.
Phototherapy
Most common and effective treatment. Baby is placed under special blue light to help break down bilirubin.
Possible Exchange Transfusion
If bilirubin levels are dangerously high or not reducing.
Blood Tests
To find the cause (blood group, G6PD, liver function, infection, etc.) Risks of Not Treating High Bilirubin: Kernicterus (bilirubin entering the brain) Permanent brain damage, hearing loss, or movement disorder
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