Rapides Clinic Sees Jaundice Treatment With New Eye

ALEXANDRIA – Jaundice affects 60 percent of all babies and, for years, hospitals simply kept jaundiced babies in the hospital under special UV lights and monitored pigment levels in the blood with repeated lab work until their conditions improved.

But now, Rapides Women’s and Children’s Hospital is offering a new “Bili Clinic.” Instead of a long hospital stay, jaundiced babies and their parents can go home and return periodically for visits to the “Bili Clinic,” where a nurse will check the newborn’s bilirubin level.

Bilirubin is the name of a pigment produced by the breakdown of red blood cells.

“With bruising during birth, bilirubin is the byproduct,” explained Muriel Edgerton, RNC. “It is excreted through urine and stool.”

But babies with immature livers can’t break down the pigment and can’t pass the pigment out of the body. And as the pigment builds up in their bodies, their skin and eyes can take on a yellow hue.

If the levels aren’t caught and corrected, bilirubin can reach the brain, causing a condition called “kernicterus” and possible neurological disorders.

“We want to catch these babies before the levels reach a point where it’s damaging,” said Vanessa Graves, registered nurse and the Rapides Women’s and Children’s Hospital nursery’s unit manager. “Jaundice is treatable and kernicterus is preventable.”

That’s why the American Academy of Pediatrics has issued a “zero tolerance” edict for kernicterus. Every baby in the hospital’s nursery is screened for jaundice.

“You can’t rely on your eyes to assess if they’re jaundiced, especially with African American babies,” Graves said. “There could be a baby who doesn’t appear jaundiced, but still has high bilirubin levels.”

A skin scan or blood test will reveal whether babies’ bilirubin levels are high or low. In some cases, babies don’t even have to get a needle stick.

In all, clinic visits usually last between 15 and 30 minutes and nurses make follow-up appointments for babies before they leave the hospital.

Connor Bryce McCown, born March 7, visited the clinic for the first time one day after being released from the hospital.

“The jaundice showed up two or three days after he was born,” said Earline Hebert, Connor’s mother. “But, it wasn’t enough for them to put lights on him in the hospital at first.”

When Connor’s bilirubin levels began to rise during his stay in the hospital’s neonatal intensive care unit, physicians used ultraviolet lights to bring the levels back down.

Now that he’s at home in Glenmora, Connor’s mom and his dad, Michael James McCown, want to make sure Connor’s levels stay that way, so they brought him to the clinic.

“They say everything’s fine,” Hebert said.

RWCH’s “Bilirubin Clinic,” which opened in late December, saw 91 babies in January and 113 babies in February.

“We had 212 births in January,” Graves said. “Half of them came back to clinic.”Some of those babies were admitted to the hospital with high bilirubin levels. Others were sent home with a prescription for home health visits and an ultraviolet “bili- blanket.”

“They stay on it every day unless you’re feeding them or changing them,” Graves said.

The blanket’s ultraviolet light breaks down the bilirubin and allows it to be excreted. Contrary to the old wives’ tale, putting your baby in direct sunlight is not a safe way to treat jaundice.

Clinic staff suggest that babies with high bilirubin levels increase the frequency of their feedings, too. For breast-fed babies, between eight and 12 times a day, in hopes of lowering bilirubin levels more quickly.