Dr. Jack
My understanding is that biliruben only appears in the urine when the bowel is
overloaded and that the bowel is the primary route of excretion. Hence giving
extra fluids to rid the system of biliruben is non productive. These kids need
to "poop it out." Is this correct? I always tell parents with jaundiced babies
to look for bili stools as a sign that the baby is getting rid of the
biliruben. (explosive stools that look like chopped cooked spinach) Often if
the provider sees that bili stools have already begun they don't run a heal
stick for bili level because they feel the baby is already eliminating the
biliruben.

<<A dipstick is available that tests for bilirubin in the urine, or you can
just look at the urine against the light. >>
This sounds like a wonderful, non invasive way of looking for biliruben.
Please tell us who makes this product and how is it used (urine collected in a
bad or from a diaper?) Is it available in the US? Given the above is true--is
this product effective?

<<What is not normal is the absence of jaundice in artificially fed babies
(formula feeding anicteris).  Physicians should rather encourage women with
babies with *hypobiliribinemia* due to artificial feeding to take the babies
of the formula for a couple of days and put them on the breast so that the
bilirubin rises into the normal range.>>
I agree whole heartedly!! It has taken several years to convince providers
that jaundice is normal. If 75 to 85% of babies get jaundiced then the ones
who don't get jaundiced are not normal.
I had heard that several researchers were looking for a physiological reason
for the elevated bili. If I remember correctly. One was going from the
standpoint that elevated bili levels may be there to prevent sepsis.  Have any
of these studies been published?  If so please share them with us.
I think we need all the ammunition we can get for doctors who still panic at
jaundiced babies and insist on formula supplementation.  I think a biological
protection factor from  elevated bilirubens might change a few minds.

Marie Davis. RN, IBCLC
Moreno Valley CA (Halfway between L.A. and Palm Springs in sunny, southern
California)