It is not uncommon for neonates to have high bilirubin levels, causing jaundice. This is because their livers are still immature and are not able to process heme at full capacity quite yet (decreased uptake and conjugation of bilirubin) and they have a higher red blood cell turnover rate than adults. The bilirubin deposits in the epithelium, causing the yellow tint in their eyes and skin. This could lead to more serious depositions in the nervous system, and possibly kerincterus.
The number one therapy is phototherapy, with blue, white, or green lights. Blue is best absorbed by the yellow bilirubin and helps metabolize it to water-soluble lumirubin, which can then be excreted. Green has a longer wavelength and may be better for protein-bound bilirubin. Phototherapy causes a systemic reduction in bilirubin levels.
Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med. 2001;344 :581 –590
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