First, I don't normally get into bilirubin in parent's classes unless they bring it up. I do use the guidelines (I think it was in Reardon/Auerbach) showing that the jaundice spreads from face and eyes, then to chest, then out the extremities-so the further out the arms and legs it goes, the higher the levels. I usually suggest if they can press over the elbow or knee and the "flash" (capilary refill) when they release the pressure is yellow instead of white, have the doc take a look. Since I'm seeing mom in my office in the hospital, I usually call the doc at their office, report my observations, and they usually have mom stop down in lab for a bili draw. Now there is a very accurate skin meter that's used on the OB unit that we hope to be able to use when we see mom/babies as outpatients and avoid the need for heel pricks.. Anyway, how to explain it in simple terms: Baby needs a higher concentration of red blood cells in utero than he does once "on the outside". Therefore, in the first days of life, baby is breaking down and processing more red blood cells than the usual day-to-day recycling that occurs throughout life. Unfortunately, sometimes baby's little liver can't quite cope with the large amount of waste it has to process, so the waste products are temporarily stored until the liver catches up. This shows up in skin as a yellow color. (further comment if appropriate:) Some of this is very normal. Experts disagree on how high the "normal" levels are. Some have even raised the question; Since it occurs to some extent with most babies, should we worry about the ones with "low" levels? While certainly not a complete scientific treatise, I think this is sufficient for most parents. i think it is important to point out the normalness of some levle of jaundice. For many adults, their only exposure to jaundice may have been another adult who had it in conjuction with some serious disease or condition. In adults, it is usually a sign of something serious, so they transfer this seriousness to their baby. It helps when they realize that jaundice is a SYMPTOM, not a disease in itself. Winnie *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html