Jaundice

An Eyewitness Account
of the Battle Between
the Courageous Erin Anneliese
and that Yellow Coward, Billy Rubin

Like all babies, Erin was checked at the hospital for jaundice, a condition in which the baby turns yellow. Jaundice is caused by the buildup of bilirubin, a by-product of the breakdown of red blood cells. Bilirubin is normally cleared from the blood by feeding; a compound in milk binds to it, where it is filtered out and excreted through the bowels. Elevated levels are treated through phototherapy (light breaks down the compound); extreme cases can be treated with transfusions. Because Erin was breastfed, and didn't get much milk for the first few days, her bilirubin levels went up after we left the hospital.

As far as we know, Erin's bilirubin levels peaked at 17.4 ml/dl on Tuesday after she was born. This isn't in the danger zone, but it's close to it. Her pediatrician called us with the report, and started the clinic on a search for a suitcase light or fiber-optic blanket for her. They weren't able to find one, and he suggested that we keep Erin near a window with her shirt off as much as possible. Some limited direct sunlight was okay, but because newborns are particularly sensitive to sun, indirect sunlight would work fine. Dr. Grier also prescribed supplementing Erin with formula so that she could get enough volume of food to process the bilirubin from her system.

At that point, the fight was on. Bilirubin was represented by Billy Rubin, a yellow coward who had wronged Erin and (in Texas terms) "done earned himself a beat-down". No offense intended to anyone, but he wore a number of personae over time, from Yankee carpetbagger to the classic Western 'citified' and cowardly villain to the spoiled brat of a Bronx diamond merchant. (Sue me, but the last name fits.)

Erin scored points by the unconventional method of bowel movements. Every soiled diaper was met with cheers of "Go, Erin! You show that mean old Billy Rubin!" or "Erin's kicking the crap out of Billy Rubin!" etc. We were a bit troubled by supplementing with formula, mainly because some of the more militant breastfeeders say that anything but a living nipple will sabotage your child's development, but we figured that a known condition trumps an unknown possibility any day.

Erin's bilirubin was checked the next few days, early in the morning, and trended downwards, slowly at first. After a few rough nights and early mornings, I realized that a 10:00 or 11:00 AM appointment would retain more parental sanity than an 8:00 AM one, so we switched to a later time for our lab visits.

At Erin's latest Well Baby checkup, her bilirubin levels show at 12 ml/dl. It's still a bit high, but is in the safe range and trending downwards. Our daughter showed Billy Rubin that his type ain't welcome here.