#asktheexpert My baby jaundice is increasing every week. Currently it is around 14.5. Last week it was around 13.5 and 12 the week before that. Please guide why the bilirubin levels are not decreasing as neonatal jaundice is supposed to go away in 2-3 weeks.

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Accepted Answer

I'm sorry to hear about your baby's jaundice. Normally, neonatal jaundice tends to improve within the first 2 to 3 weeks after birth. However, if the bilirubin levels are continuing to rise or not decreasing as expected, it could indicate that something else is going on. There are several potential reasons for this:

1. Breastfeeding Jaundice

Cause: If your baby is breastfeeding but not getting enough milk (especially in the first few days after birth), it can lead to dehydration, which may cause a mild increase in bilirubin levels.

Solution: Ensure that your baby is feeding regularly (8-12 times a day). If breastfeeding is difficult, you might need to supplement with formula temporarily.

2. Breast Milk Jaundice

Cause: Some babies develop jaundice due to substances in breast milk that may interfere with the liver's ability to process bilirubin. This typically appears after the first few days of life and can persist for several weeks.

Solution: While it’s usually harmless, it's important to continue breastfeeding unless advised otherwise by a healthcare professional.

3. Liver Issues

Cause: Liver problems or bile duct obstruction could lead to elevated bilirubin levels, causing jaundice to persist longer than expected.

Solution: Your doctor might recommend tests to assess liver function and rule out any liver-related conditions.

4. Hemolysis (Destruction of Red Blood Cells)

Cause: If your baby’s red blood cells are breaking down more quickly than normal (hemolysis), the liver may not be able to process all the bilirubin. This can occur due to blood type incompatibility (e.g., Rh or ABO incompatibility).

Solution: Your doctor will likely run tests to check for blood type incompatibilities and other causes of hemolysis.

5. Infection

Cause: Sometimes, a bacterial infection (like urinary tract infections) can cause a spike in bilirubin levels.

Solution: If your baby has any signs of infection (fever, lethargy, poor feeding), it’s important to consult a healthcare provider.

6. Genetic Conditions

Cause: In rare cases, genetic conditions like Gilbert’s syndrome or other disorders affecting bilirubin metabolism can lead to prolonged jaundice.

Solution: If there are other symptoms or a family history of such conditions, your doctor may order genetic tests.

7. Delayed Treatment

Cause: If jaundice is not treated early with interventions like phototherapy, bilirubin levels can continue to rise.

Solution: Depending on bilirubin levels and the baby’s age, phototherapy (light treatment) is often used to help break down excess bilirubin.

What to Do:

Consult a Pediatrician: It’s crucial that your pediatrician closely monitors your baby’s bilirubin levels and identifies the underlying cause. They may order tests such as blood work, liver function tests, or a urine culture.

Follow Medical Advice: If phototherapy or other treatments are recommended, it's important to follow the guidance given by your healthcare provider.

Persistent jaundice should be evaluated thoroughly to rule out any complications. Make sure to track the symptoms and inform your doctor of any changes in your baby's condition.