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Bilirubin Testing in Newborn

Testing for bilirubin in newborn should be universalized in all hospitals. Bilirubin is a product of hemoglobin found in bile which can cause jaundice, and, in more sever cases, mental retardation or developmental disabilities. Normally bilirubin passes through the liver and is excreted through the intestines as bile; however, a buildup of bilirubin in the blood can cause the skin to take on a yellow discoloration known as jaundice.
Jaundice affects 60% of newborns and it can be effectively treated through phototherapy which can be done at home or in the hospital. Jaundice signals a risk for a severe neurological disorder known as kernicterus. Kernicterus is a serious disease that can be largely prevented. It virtually disappeared in the 1970s but has reemerged over the past decade. Whereas in the past, kernicterus testing may not have been prioritized, the need for it has increased in the present. The professor of pediatrics at Stanford University School of Medicine who runs a voluntary registry for reporting kernicterus, estimates there are 75 to 100 cases a year in the U.S.
A study supported by National Institute of Child Health and Human Development reported that universal screening led to more children being treated with phototherapy who did not actually need it, and slightly longer hospitalizations after birth.
Universal testing for bilirubin is, however, more beneficial than harmful. It would reduce the number of re-admission rates, and there would be a significantly less chance of a baby developing kernicterus. Even though children who do not necessarily need to undergo treatment for excessive levels of bilirubin would be treated when bilirubin testing is mandated, the children who must be treated would undoubtedly be treated. The test costs less than a dollar, and causes minimal pain to the child.
Hospital Corporation of America, with 190 hospitals, conducts bilirubin testing in all newborn, and acts as a role model for all hospitals. Many legal cases have been made regarding a hospital’s negligence to test the total serum bilirubin level, thereby failing to prevent the onset of kernicterus in the child. Some hospitals test for high bilirubin levels by simply examining the outward appearance of the child, judging by the yellow discoloration of the skin. This procedure is not effective, and a better system should be adopted.
I propose a new law to be created to mandate bilirubin testing in newborn in all hospitals. This would significantly decrease, if not eliminate, the chance of learning or development handicaps.



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