Is A Total Bilirubin Level Of 2 In An Infant After A Week Of Birth Normal?

Posted on Sat, 8 Oct 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 8 Oct 2016 Answered on

Wed, 2 Nov 2016 Last reviewed on

Question : I have a one month old son. At the hospital when he was born, on the third day they tested him for bilirubin and his total bilirubin was 8 and direct was 0.8 and he received phototherapy overnight. On the fourth day at the hospital we were discharged and asked to follow up the next day with the pediatrician because he lost some weight. Birth weight was 7 lb 13oz and day of discharge weight was 7 lb 8 oz. two weeks after bilirubin was rechecked at total was 3.6 and direct was 0.6. He gained weight and has been eating well breast fed also supplementing with formula. One month check up and total bilirubin came down to 2 and direct bilirubin is 0.6. Doc doesn't seem concerned since levels are coming down and wants to recheck on 2 month appointment. Baby has gained weight and eating well (breast milk and formula) stools are mustard yellow to brown in color. My question is- should I be concerned? shouldnt have his bilirubin levels been normal by now? Should I go get a second opinion since this doc isn't too concerned? I'm just worried and want to know what's going on with my baby. I also hear mothers with blood type O bilirubin in infant takes longer to excrete - why is that? I am blood type O.

Answered by Dr. Diptanshu Das (24 minutes later)

Brief Answer:
Not a cause for concern.

Detailed Answer:
Thanks for asking on HealthcareMagic.

Let me emphasize on the fact that breast milk is the best possible milk for a baby and there can be no alternatives for the same. Most formula milks are cow milk based and hence difficult to digest. Mother's breast milk is produced on the demand of the baby. Hungrier the baby, more vigorous is the suck. More is the suck, more is the amount of breast milk produced. Giving formula automatically reduces the demand of the baby and thereby the production of breast milk. All you need to do is to switch back to exclusive breast feeding and the production will increase automatically. All you need to do is to monitor the urine output. If the frequency is more than 6 times in 24 hours, you would know that the amount of feeding is adequate. If the amount of passage of urine is less or if the child is lethargic you would need to take the child to a doctor without delay.

The level of bilirubin is not a cause for concern. Before birth the child has a hemoglobin level higher than the mother so that the baby can extract oxygen from maternal blood. The requirement ceases to exist once the child is born. The extra hemoglobin breaks down to form bilirubin. It is normal and not a cause for concern. If on occasions the bilirubin level rises all you need to do is to give increased amount of breast feeding.

In case mother has O blood group, there remains a possibility of ABO incompatibility. Had it occurred, it would have clearly shown up soon after birth. That is not the case here and you need not worry. It does not take more time for bilirubin to be excreted if the mother than O blood group.

Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar