Jaundice: Bad or Good?

Assumption: The newborn body cannot cope with high levels of bilirubin and those who become jaundiced must be treated.

TRUE… but
Apparently, many studies have sought to determine whether bilirubin is a good thing or a bad thing.  This article pulls the studies together and comes to a couple of conclusions: (1) Bilirubin definitely has positive properties- mainly as an antioxident, but (2) bilirubin that is out of control can be very dangerous to the newborn brain.

http://pediatrics.aappublications.org/content/113/6/1776.full.html

My Views:
After my last post, I began to wonder, WHY do so many newborns (60% full-term and 80% of premature infants) become jaundiced if it is such a terrible thing?  Why is this such a naturally and normally occurring phenomenon?  The good news is that bilirubin is an antioxident that has proven to help infants is several ways (see the article for specifics), including protecting the body from toxins.  The bad news is that if the bilirubin numbers become too high, brain damage can occur.  So, it is still wise to treat jaundice and to keep track of levels.  What levels are acceptable and what levels need to be treated are under some debate in the medical community.  I’m just glad to know that there is a natural purpose to the jaundice itself and that 60-80% of our babies aren’t just born “out of whack.”

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Delayed Cord Clamping: Disadvantages

Assumption: There are advantages to immediate cord clamping.

TRUE
Yesterday I said I would try to find out of there was any particular *advantage* to immediate cord clamping.  It seems there must have at some time been some advantage or it would not be such a widespread practice, right?  The studies analyzed here show that delayed clamping/ cutting does not lead to more maternal hemmorages (as previously theorized) and it does help babies’ iron stores.  BUT, the babies whose cords were clamped 2 minutes or more after birth did tend to develop more jaundice.

http://www2.cochrane.org/reviews/en/ab004074.html

My Views:
First, although low iron and jaundice can contribute to the risk of brain damage, I think that iron levels are more important since jaundice can be remedied in very non-invasive ways (frequent breastfeeding and exposure to sunlight) and is more apparent and easy to detect.  Second, I now wonder if there might be a benefit to some (low-level) jaundice at birth since so many babies experience it.  My personal opinion after reading these studies is that the delayed cord cutting has more benefits than risks and that it should be studied and practiced more.