Host: A very common concern of parents when the babies are a couple of days older and yellow, and the pediatricians start to check the thing called bilirubin. What is that all about?
Oded Preis: When the baby is born, one of the changes that appear in his body is that he starts to break down some of the fetal hemoglobin, that is a type of hemoglobin that circulates in his red cells, while he is developing as a fetus. The breakdown of this hemoglobin will create a pigment called bilirubin, that at very high levels, is potentially toxic to the brain. Insides of the womb, while the baby is developing, the placenta is actually doing the filtering, the cleaning and the picking up of this waste products that gets excreted into baby's ducts or back into the mother's circulation.
Once the baby is born, in essence, the liver of the baby needs to pick up that bilirubin and dispose of it. Maybe sometimes they delay in the liver's ability to do that, and when that happens some of this pigment will accumulate in baby's circulation, giving the baby's skin color a little yellowish tinge. In most instances, it is not a problem, actually some people feel that bilirubin actually protects the baby, because it's an antioxidant, and if at high levels, they maybe damaging to the brain, we may have to address this issue, and lower the bilirubin level. So if the bilirubin is say, of a mild or moderate level, and there is really no reason to do anything, because it will actually run its own. If it does present to be a problem, and we have ways of addressing it, and treating it.
Host: There is a condition where the mother's blood, which should be O, and the baby's blood could be A or B, is that a problem?
Oded Preis: Potentially it could be a problem, because the mother has natural antibodies against the baby's red cells. Antibodies are immune globulin, that may actually attack the baby's red cell and cause them to breakdown a little faster. That's creating more bilirubin as part of the by-product or say, the destruction of the red cell, and may cause a problem with the rapid rise of bilirubin. These are type of situations do require, monitoring closely, and at times we may have to address the rising of bilirubin by using various treatment modalities, and lowering the bilirubin a little faster. That is definitely something that a pediatrician can very easily determine by doing a bilirubin level, monitoring the rate of rise of the bilirubin, and if necessary initiate a therapy to protect the baby.
Host: Also, when the kid goes home, the doctor watches the kid's blood because sometimes they get a little anemic.
Oded Preis: Absolutely. Normally babies will get anemic usually between six weeks and three months, because of the fact that they breakdown their fetal red cells. Obviously if there is a process that they facilitate or enhances that breakdown, then they may become somewhat anemic, faster and they may require watching the baby, and maybe adding a bit some iron therapy to the baby, and in a rare, rare situation, the baby may even need a transfusion, but these are really rare conditions.
Host: So generally it's watchable, and most of the time it doesn't need too much care?
Oded Preis: In most instances, the baby's natural processes and physiology will correct itself.
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