May 4th, 2009...
The word “jaundice” means “yellow.” Most babies are a nice pinkish color, but some turn funny shades of yellow. Lucy is currently a nice shade of orange and the “whites” of her little eyes are also a nice shade of yellow. Jaundice is caused by a build up of a chemical known as bilirubin in her bloodstream and body tissues, including her skin. According to the medical supply dude, Doug, it often builds up in areas such as knees and elbows because it can “pool.” Bilirubin is a waste-product of old red blood cells that the body no longer needs. Under normal circumstances, the liver filters the bilirubin from the blood and passes it to the bowel to be removed from the body in the bowel movements.
Resources online state that some newborn babies produce bilirubin faster than their bodies can eliminate it. This generally happens because 1) Early in life, newborn babies have to take their fetal red blood cells out of circulation and replace them with new, adult-type red cells. Disposing of the fetal red blood cells can load their bodies with a lot of bilirubin in a short amount of time; 2) The body systems, especially the liver, that usually process bilirubin and change it into an easily disposable form are not very efficient in the newborn, especially if the baby is a few weeks premature (WHICH TOTALLY APPLIES TO LUCY); and 3) The only way for bilirubin to actually leave the body of a newborn is in the bowel movements. Babies who don’t nurse vigorously or often enough might not have enough bowel movements to eliminate the bilirubin from their bodies. Newborn jaundice is usually gone by about 2 weeks of age. However, it should be “fading” after it peaks around the 4th or 5th day of life. In other words, your baby should not still look as jaundiced at one week old as he or she did when 4 or 5 days old. The bilirubin level changes over time, and it could still be going up. Unfortunately, bilirubin is not like blood pressure or cholesterol, where you can look up what “normal” is, and then compare your baby’s bilirubin level to that normal value. It’s much more complicated because a very wide range of bilirubin levels are considered normal in the first week of life for healthy term newborn babies. Doctors and nurses uses special graphs to precisely determine what is normal (or too high) for each individual baby at a specific point in the baby’s life.
So why am I telling you about all this? Well, poor little Lucy was discharged from the hospital on Thursday and since then, we have been taking daily trips to the lab where they take blood from her heel for a bilirubin test. On Thursday when we left the hospital, her level was 11.2, but then it peeked on Friday at 18.9 and has since gone down to 16.9 (as of earlier today). BUT… this process hasn’t occurred without much assistance! She has been attached to a medical device called a “biliblanket” (I’ve attached a photo below of Lucy’s “power pack” or “personal tanning booth”- two names that we’ve been calling it) for as many hours as humanly possible each day; which means, that we have been within 9 feet of an electrical outlet at all times since Friday evening to assure optimal phototherapy results. 
In most cases, jaundice is treated with a little sunlight; however, because Lucy’s peeked so high and so quick, she has been receiving phototherapy since Friday evening (thus the visit from “the medical supply dude, Doug” that I mentioned earlier). Dr. Roberts, the pediatrician who was covering for Dr. Sola-Gomez on Friday prescribed a “biliblanket” for Lucy. The biliblanket provides the highest level of therapeutic light available with a pad of woven fibers (it looks like a thick belt that goes from under her arms to her belly button and wraps all the way around her abdomen, around her back, and connects to itself in the front). The covered fiberoptic pad is placed directly against her skin to provide the optimal amount of light. Absorption of this light leads to the elimination of bilirubin. Most babies require the biliblanket for several days- we will know more tomorrow about the next step in Lucy’s treatment because we have to get her blood tested when the lab opens and then head to our first visit to see Dr. Sola-Gomez.
Stay tuned for more updates as they come in and as I can run away from baby duties for a few minutes to type something… something that is hopefully coherent and written in a manner that is easily understandable.
