Wow, what an excellent explanation Jennifairy! For the very first time in my career as a midwife, I see the light!! (no pun intended)
Tania x Hi Ramona, my understanding of this is that the bilirubin is produced when the fetal red blood cells are broken down by the liver (adult red blood cells start being produced at this stage). So the bilirubin is in the bloodstream, where it gets bound to albumin, which is a protein in the blood serum that often binds with and hence transports fatty acids, (like bilirubin). So this bilirubin that has connected with the albumin (its called "unconjugated" bilirubin) gets back to the liver, where it combines with glucuronic acid to become "conjugated" bilirubin. Now its water soluble, and can be excreted through the kidneys and intestines as wee & poop. So, it follows that the more the baby intakes, the more it excretes, which gets rid of the bilirubin. The unconjugated stuff will just keep on circulating until it goes through the process of conjugation in the liver, or it can also become conjugated in the small blood vessels of the skin when exposed to light (which is what the phototherapy is all about). It still then needs to be excreted through the digestive system. hope this helps, cheers -- Jennifairy Gillett RM Midwife in Private Practice Women’s Health Teaching Associate ITShare volunteer – Santos Project Co-ordinator ITShare SA Inc - HYPERLINK "http://itshare.org.au/"http://itshare.org.au/ ITShare SA provides computer systems to individuals & groups, created from donated hardware and opensource software -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.6/536 - Release Date: 16/11/2006 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.6/536 - Release Date: 16/11/2006
