Question

What is the normal “bili total” of neonates? What is the normal range for the “bili direct?”

Answer 1

In neonates bilirubin levels fluctuate a lot. This fluctuation in bilirubin varies depending on several factors such as full-term or pre-term child, breastfed or bottle-fed child etc. Because of this fluctuation there is no absolute normal value of bilirubin in neonates unlike adults.

Many babies have jaundice which is considered physiological.Usually Serum total bilirubin (STB) level usually peaks by 3 days of age and then falls in term neonates. There is no clear cut demarcation between pathological and physiological jaundice. STB levels have been arbitrarily defined as pathological if it exceeds 5 mg/dL on first day, 10 mg/dL on second day, or 12-13 mg/dl thereafter in term babies. Upper limit for direct bilirubin is 2mg/dl at any point.