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Warning-sign checks

Bilirubin encephalopathy: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Emergency evaluation is needed for poor responsiveness, stiffness, marked floppiness, arching, breathing difficulty, or seizures.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Between visits, caregivers should seek prompt advice if jaundice appears to deepen, feeding worsens, or the baby becomes sleepier than usual.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up may include weight checks, feeding assessment, repeat bilirubin measurement, and review of urine and stool output.

    Parents and caregivers should receive a clear plan for when and where the baby will be reassessed.

    Babies with suspected or confirmed bilirubin encephalopathy may need longer-term follow-up with specialists.

    Care can include formal hearing testing, developmental assessment, physical or occupational therapy, speech and feeding support, neurology care, and early-intervention services.

The article also says

After phototherapy, the care team may repeat bilirubin testing because the level can rise again when treatment stops.

The timing depends on the baby’s age, gestational age, bilirubin level, treatment course, and risk factors.

Every sign above is quoted from the sofidex article on Bilirubin encephalopathy. If you are not sure, err upward — it is always reasonable to be checked.