Q: My daughter developed jaundice 12 hours after she was born. It was due to the fact that her blood type was different than that of her mothers - Rh+ while the mother was Rh-. After a week her bilirubin was at 16.8 and then went down to 12.3 five days later. The doctor prescribed Gardenal tablets to be taken for 10 days and then we would have yet another blood test. Is this an effective drug? Will she ever recover from this disorder? Is it at dangerous level?

A:The fact that your daughter got jaundice within 12 hours shows that it is perhaps not a case of physiological jaundice which generally occurs in 2-5 days after birth and then goes away. However the possibility of physiological jaundice cannot be totally ruled out. I am not very sure that the disorder is due to Rh factor. In order to diagnose HDN (Haemolytic Disease of the Newborn - HDN) due to Rh incompatibility, the infant should be Rh negative and mother should be Rh positive so that the antigen D gets transferred from the mother to the child. In any case, the treatment is correct. Gardenal is the brand name of phenobarbitone which is an enzyme inducer and helps to reduce bilirubin. Please do get bilirubin tested weekly to make sure that it is coming down. In case its downward trend does not continue the diagnosis should be reviewed. A level of 20 mg bilirubin or more is dangerous because it can affect the brain. However 16.8 which has now come down to 12.3 mg is not risky.