Bilirubin is a substance that is produced during the process of hemolysis. Hemolysis is the process where red blood cells are destroyed. This is a normal process when it comes to dealing with older red blood cells. However, it is not normal if the rate of hemolysis is extremely high. Bilirubin has a yellow colored pigment. This explains why urine is yellow in color. Most of the bilirubin gets processed in the liver and passed out through the bile ducts. Processed bilirubin is known as conjugated or direct bilirubin. Unprocessed bilirubin is known as unconjugated or indirect bilirubin.
When it comes to unconjugated bilirubin in newborns, this value tends to be higher than the normal value for adults. The placenta is responsible for removing unconjugated bilirubin when the baby is still in the mother's womb. In most cases, the normal functioning of the baby's liver system will ensure that this difference in the value of bilirubin corrects itself over time. Many cases of high unconjugated bilirubin in newborns will result in jaundice. The birth of a child with jaundice is not uncommon. Such children need to be treated immediately to ensure that no long term damage occurs because of the elevated level of bilirubin. There are many different conditions that can cause elevated unconjugated bilirubin in newborns. These include hemolysis, syphilis, hemorrhage and a number of other toxic conditions. It is important to determine which form of disease the infant is suffering from.
In some cases, the baby's position in the womb may affect the level of direct bilirubin in newborns and indirect bilirubin in newborns as well. There have been cases where an entanglement of the umbilical cord has led to the development of high levels of unconjugated bilirubin in newborns. When there is indirect bilirubin in infants, it is highly likely that the infant will also suffer from malnourishment. Such cases may be detected even before birth. In such a situation, a surgical birth may be prescribed as the chances of the child surviving a normal birth will be reduced.
Direct bilirubin in newborns should be processed through the liver and bile system of the infant. A failure of any of these systems due to development problems will lead to an increased level of direct bilirubin. This will also cause jaundice which will be clearly visible. The diagnosis of the type of bilirubin and the underlying cause is therefore essential at this early stage in the child's life.