Let’s try and keep prolonged jaundice out of A and E!!

Most babies who are still jaundiced at 2-3 weeks of age are well.  It is important not to miss biliary atresia  which presents as CONJUGATED hyperbilirubinaemia.  The baby will usually, though unfortunately not always, have pale, putty-coloured stools and it is important to pick them up early as the treatment is surgical and has a better outcome if carried out around the age of 6 weeks.  The community midwives in Waltham Forest do the first line investigations for prolonged jaundice.  The following documents are downloadable here:

1)  Prolonged jaundice guideline for midwives

2)  Investigation sheet for prolonged jaundice

We try very hard to keep these babies out of the Emergency Department as they run the risk of coming in well and going out with something they’ve caught while waiting to see us.  They also have to be put in a cubicle and then there is no room for A and E to see all the other children in the department.

2 thoughts on “Let’s try and keep prolonged jaundice out of A and E!!

  1. my second child was female, she had jaundice after 1 week of birth. total bilirubin after 1 week in check is 8.18, date 20-08-2011, and the date 24-09-2011 (1 month and 12 days) checked back with the results of a total of 8.
    total direct declined from 1.4 to below 2 1:16.
    how do you think, if it needs a very serious treatment?

    thanks & Regard

    Wahyu _ Indonesia _ West java _ bandung

    1. Selamat siang Wahyu and thank you for your comment. I found it a little difficult to understand your figures. It seems to me that in Indonesia the doctors use g/dL as the unit of measurement of bilirubin whereas we use micromol/L. I therefore have to multiply the figures you gave me by 17.1 to get values that I am familiar with! A total bilirubin of 8g/dL is not very high at either 1 or 6 weeks of age, especially if you are breastfeeding. However, as a paediatrician, I would want to properly check out any baby with a direct bilirubin (sometimes called unconjugated or split bilirubin) of 1.46 (25micromols/L) or above at her age to make sure there wasn’t any blockage near her liver. I can’t work out from your message what your daughter’s current direct bilirubin is but I suggest if you are concerned that you take her to see your own doctor soon to discuss this with them and get her checked out if necessary.

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