The body converts hemoglobin released from damaged red cells into bilirubin. The liver removes the bilirubin from the blood and excretes it into the bile, which is released into the small intestine to aid digestion.

Normally there is only a small amount of bilirubin in the bloodstream. Bilirubin rises if there is excessive red blood cell destruction, or if the liver is unable to excrete the normal amount of bilirubin produced.

There are two types of bilirubin: indirect (also called unconjugated) and direct (also called conjugated). An increase in indirect (unconjugated) is seen when destruction of red cells has occurred, while an increase of direct (conjugated) is seen when there is a dysfunction or blockage of the liver.

If excessive amounts of bilirubin are present in the body, the bilirubin seeps into the tissues, producing a yellow color called jaundice.

If your childs total bilirubin rises above normal levels, ask the physician for an explanation and plan of action.

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