New Program for Babies Helps Prevent Brain Damage from Common Disorder
02/27/2007

FORT WORTH, Texas — A new program at Harris Methodist Fort Worth Hospital (HMFW) is identifying newborns at risk for brain damage due to hyperbilirubinemia — a common disorder characterized by elevated levels of bilirubin in the baby’s bloodstream.

The Hyperbilirubinemia Assessment Program was created by Texas Health Resources, HMFW’s parent company. Since the hospital introduced the program in July, more than 350 babies have been assessed.

Hyperbilirubinemia, a condition commonly known as jaundice, affects up to 60 percent of newborns and often occurs within the first week of a baby’s life. If undetected and untreated, severe jaundice can lead to a brain damaging condition called kernicterus, which can result in hearing loss, mental retardation, behavior problems or death.

“Many babies become jaundice,” said Debbie Phillips, R.N., M.S., F.N.P., director of Community Health and Education at HMFW. “What we worry about is babies who get too jaundiced. We begin to see the characteristic yellow tint of the eyes and the skin below the abdomen. The babies become lethargic and have trouble feeding.”

In recent years, the Joint Commission on Accreditation of Healthcare Organizations has identified hyperbilirubinemia as a significant issue that health care providers should closely monitor for the health of newborns.

“We are setting a standard with this program,” said Amy Hailey, director of Women and Infants’ Services at HMFW. Hailey helped lead the effort to develop this program for THR hospitals. “We are proactively offering a resource that parents can easily access to protect and improve the health of their newborns from a common, yet potentially dangerous, health issue.”

Early Detection is Key
A newborn’s bilirubin levels are already monitored while in the hospital. Through the new program, physicians write orders for parents and their new babies to return to the Harris Methodist Fort Worth Hospital Hyperbilirubinemia Assessment Clinic two days after discharge — typically the time when jaundice is at its peak — so that babies can be reevaluated. The clinic is located in the hospital’s Breastfeeding Resource Center.

“If breastfed babies are not feeding well, they are more likely to become jaundiced because hydration is needed to flush out the bilirubin from their bodies.” Phillips said. “About 75 percent of mothers leave our hospital breastfeeding, so the hyperbilirubinemia assessment gives us the opportunity to also work on their breastfeeding issues, which will help with the jaundice. We get to take care of two issues at once, and that kind of convenience is always better for mother and baby.”

Early detection of potentially dangerous bilirubin levels is key to preventing kernicterus. During the assessment, nurses first administer a transcutaneous test that measures bilirubin non-invasively. If levels from this test are elevated, a blood test is performed for a more in-depth reading.

Logan’s Story
Like many newborns, evidence of baby Logan Sivecz’s jaundice began to appear about 24 hours after his Sept. 26 birth, just when parents Kimberly and James were preparing to take him home.

Before being discharged from the hospital, Kimberly’s pediatrician cautioned her to watch for advancing signs of the disorder and, as a precaution, asked her to take Logan to HMFW’s Hyperbilirubinemia Assessment Clinic for testing everyday for the following three days. That was a Thursday.

By Sunday, Logan was being admitted to Cook Children’s Medical Center for phototherapy treatment after tests from the HMFW clinic revealed elevated levels of bilirubin in his tiny body.

That hospitalization lead to an additional discovery that Logan’s platelets and white blood cell counts were low, putting him at high risk for infection. The newborn spent five days in the hospital receiving treatment for both ailments and underwent an additional three days of home-based phototherapy.

“Blessings come in strange disguises,” Kimberly Sivecz said following son’s bout with jaundice and their experience with the Hyperbilirubinemia Assessment Clinic. “If not for the jaundice and the clinic’s monitoring, we might not have discovered these other medical issues as early as we did.”

Signs, Symptoms and Treatment
Everyone’s blood contains bilirubin, which is a byproduct of red blood cells and is removed by the liver. Babies are born with a high amount of red blood cells. As babies make the transition to life outside the uterus, their bodies break down old red blood cells, which releases bilirubin, and make new ones. The bilirubin sometimes builds up faster than the baby’s immature liver can process, leading to jaundice.

Symptoms of jaundice include a yellowing of the skin beginning in the face and progressing down the body, lethargy, fussiness, trouble nursing and the absence of wet diapers and stools.

The most common treatment for jaundice is phototherapy, where fluorescent light is used to break down bilirubin. More severe cases, and those caused by an underlying medical condition, may require hospitalization for a blood transfusion or other treatment.

For more information about the Hyperbilirubinemia Assessment Clinic, call 817-250-BABY. For more information about the Breastfeeding Resource Center, follow this link.

About Harris Methodist Fort Worth Hospital
Opened in 1930, Harris Methodist Fort Worth Hospital is a Magnet-designated hospital, and Tarrant County’s largest and busiest hospital and regional referral center. A member of Texas Health Resources, HMFW is licensed for 710 beds and provides the following services: cardiovascular; high risk and routine obstetrics and gynecology; neurosciences; orthopedics and sports medicine; rehabilitation; adult critical care and neonatal intensive care; trauma and emergency medicine; cancer care; medical/surgical; kidney transplants; occupational health; and more. The campus is home to almost 1,000 members of the medical staff, more than 4,000 employees, 200 volunteers and the new state-of-the-art 100-bed Harris Methodist Heart Center. For more information, please call 1-888-4-HARRIS, or visit www.texashealth.org/hmfw.

About Texas Health Resources
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served. THR’s system of 13 hospitals includes Harris Methodist Hospitals, Arlington Memorial Hospital and Presbyterian Healthcare System, and a medical research organization. THR is a corporate member or partner in six additional hospitals and surgery centers. For more information about Texas Health Resources, visit www.texashealth.org.