What is the preferred treatment for mild and severe unconjugated hyperbilirubinemia in infants?

The preferred treatment for mild and severe unconjugated hyperbilirubinemia in infants involves using phototherapy for mild cases and exchange transfusion for severe cases.

Phototherapy works by using light to convert bilirubin into water-soluble isomers that can be excreted without the need for conjugation in the liver. This treatment is generally safe and effective for managing mild cases of hyperbilirubinemia, helping to reduce elevated bilirubin levels without invasive procedures.

In contrast, severe unconjugated hyperbilirubinemia presents a higher risk for complications like kernicterus, which is a serious condition caused by bilirubin toxicity in the brain. When bilirubin levels reach a critical threshold (often above 20 mg/dL or depending on clinical factors), exchange transfusion becomes necessary. This procedure involves replacing a portion of the infant’s blood with donor blood to rapidly decrease bilirubin levels and prevent potential neurological damage.

The distinction between phototherapy and exchange transfusion is critical in managing hyperbilirubinemia effectively, ensuring that treatment is tailored to the severity of the condition to optimize outcomes for the infant.