Can a 1-month-old baby with hyperbilirubinemia get a light?

Question
The doctor told me that my baby is 1 month old and still has jaundice, I gave him a test for total bilirubin of 368, direct bilirubin is 17. The doctor made an appointment after 1 month when the baby did not get better, then he went to the screening. lights, but 1 week baby did not help, so I took her to test again total bilirubin is 394, direct is 14.5. I asked the doctor to let the baby go to the hospital for light, but the doctor said that the baby is too old for the lamp, only children under 10 days can use the lamp, the family sent him back to monitor, my baby is now 1 month old It's been a day, now what should my family do? (2 visits are 2 different doctors, the first one said to go to the hospital with light and the second one said no). Can a 1-month-old baby with hyperbilirubinemia be exposed to light? Ask your doctor for advice!
Bui Thi Nga (Hanoi)
Answer
Answered by Dr. Ho Thi Hong Tho - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.
Hello friend,
With the question: "Can a 1-month-old baby with hyperbilirubinemia get a light?" The doctor's answer is as follows:
Jaundice caused by indirect hyperbilirubinemia in newborns is a condition of increased destruction of red blood cells, with decreased function of the enzyme that metabolizes bilirubin, or due to increased reabsorption of bilirubin from the intestine. Neonatal jaundice in babies can be detected early through the following signs:
Observe the baby with the naked eye. Transdermal bilirubin measurement. Determination of bilirubin in serum. Jaundice can be physiological, usually appearing on the 2nd day after birth and gradually decreasing when the baby is 1 week old (for full-term babies) and 2 weeks (for premature babies). If the measurement of bilirubin is less than 12 mg/dl (for full-term infants) and less than 15 mg/dl (for premature babies). Direct bilirubin measurement with a bilirubin index of less than 2 mg/dl.
Pathological jaundice usually appears on the first day of birth. Bilirubin levels increased rapidly, greater than 0.2mg/dl/hour. The baby sucks poorly, is lethargic, has rapid breathing or stops breathing, and has a change in body temperature. Liver, spleen enlargement or anemia. Thus, your baby has high bilirubin levels and late jaundice after 2 weeks. The reason for that late appearance may be due to breast milk, or the child has biliary obstruction, liver disease, congenital hypothyroidism or other metabolic diseases. You should see a pediatrician to rule out genetic diseases.
Regarding the problem of yellow light exposure, this is still an effective measure to reduce free Billirubin for the baby, but the baby is 1 month old, it is not necessary to use the lamp anymore.
If you still have questions about 1-month-old baby having jaundice with hyperbilirubinemia, you can go to a hospital under Vinmec Health System for examination. Thank you for your interest and question to Vinmec.
Best regards!