Neonatal Bilirubin (Neo-Bilirubin) Test
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About Neonatal Bilirubin Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Newborn bilirubin test, total serum bilirubin (TSB), neonatal hyperbilirubinemia test |
| Sample Type | Blood (capillary blood from heel prick) |
| Fasting Required | No fasting required |
| Report Time | Same day to 24 hours; within 3 hours for urgent cases |
| Recommended For | Newborns aged 0 to 28 days, male and female |
| Price | Starting at ₹150 |
What Is a Neonatal Bilirubin Test?
A neonatal bilirubin test measures the level of bilirubin, a yellow pigment released when red blood cells break down, in a newborn baby's blood. Also known as the newborn bilirubin test or total serum bilirubin (TSB) test, it helps doctors determine whether a newborn has jaundice and whether treatment is needed.
While a healthy liver normally breaks down and removes bilirubin, a newborn's liver is still developing and may struggle to keep up. The TSB test allows doctors to monitor bilirubin levels closely and step in early if they rise to a concerning level.
What Does a Neonatal Bilirubin Test Measure?
The neonatal bilirubin test measures different types of bilirubin in your baby's blood. Knowing each type helps your doctor understand how well the liver is breaking down this pigment.
| Parameter | What It Measures |
|---|---|
| Total Bilirubin | The full amount of bilirubin in the blood, combining both direct and indirect forms |
| Direct (Conjugated) Bilirubin | Bilirubin that has already been processed by the liver and is ready to be removed from the body |
| Indirect (Unconjugated) Bilirubin | Bilirubin released after red blood cell breakdown, which the liver has not yet processed |
Around 85% of bilirubin comes from haemoglobin in red blood cells; the remaining 15% comes from red blood cell precursors in the bone marrow.
Why Is a Neonatal Bilirubin Test Done?
Doctors may recommend the newborn bilirubin test either when your infant is showing signs of jaundice or when they wish to monitor bilirubin levels after birth.
Common Symptoms That May Require This Test
If your newborn has high bilirubin levels, you may notice the following symptoms:
- Yellow colouring of the skin, beginning on the face and spreading downward
- Yellowing of the whites of the eyes
- A yellow tint is visible under the tongue
- Poor feeding or difficulty latching during nursing
- Excessive sleepiness or difficulty waking for feeds
- Not as many wet or dirty nappies as expected
- Crying that is high-pitched or strange
- If your baby has one or more of these signs, a doctor may suggest testing to find out how serious their condition is.
Conditions This Test Can Help Detect
This test can help identify a range of conditions, including:
- Physiological jaundice, the most frequent kind, appears in most newborn babies on the second or third day after birth
- Breastfeeding jaundice
- Breast milk jaundice
- Blood group incompatibility (Rh or ABO incompatibility)
- Haemolytic anaemia
- Liver or bile duct problems
- Rare genetic disorders, including Crigler-Najjar syndrome, which affects the body's ability to process bilirubin
How to Prepare and What to Expect
Sample collection for the neonatal bilirubin test is a simple process that takes only a few minutes.
Do You Need to Fast?
No, fasting is not required. Your baby can continue their normal feeding schedule before and after the test. If your doctor has ordered additional tests alongside this one, they will let you know if any other preparation is needed.
Practical Tips Before Your Test
Here are some important tips to remember before the test:
- Ensure that your baby is warm and comfortable before the test because warmth facilitates blood circulation to the baby's heels
- Dress your baby in loose clothing for easy access to the foot
- Let the doctor know about any medication that the baby might have taken
- Note the timing of your baby's last feed before the appointment
- Keep a support item or be ready to nurse your baby immediately after the procedure
Step-by-Step Procedure
The test is quick, minimally invasive, and usually completed within a few minutes. Below is an overview of what to expect.
- Your baby’s heel is wiped clean using an antiseptic wipe
- A trained healthcare professional uses a small, sterile lancet to make a tiny prick on the side of the heel.
- A few drops of blood are gently collected into a small tube or onto a test strip.
- The heel is gently pressed to prevent any further bleeding.
- A small bandage is placed over the prick site.
- The blood sample is then labelled and sent to the lab for testing.
Your baby may cry briefly during the prick. However, they will typically settle quickly with a cuddle or a feed.
Factors That Can Affect Accuracy
The following are some of the factors that could affect the accuracy of the TSB test:
- Gestational age, body weight, and skin colour can affect the accuracy of transcutaneous (skin surface) bilirubin readings
- Hemolysis (the destruction of red blood cells in the blood sample) and the presence of high levels of fats in the blood could lead to erroneous results
- Samples exposed to light for too long before analysis may give inaccurate readings
- Phototherapy treatments could influence the levels of bilirubin
- Dehydration in the newborn may affect results
Understanding Your Neonatal Bilirubin Test Results
The neonatal bilirubin test results must always be reviewed alongside your baby's age in hours, gestational age, and overall health. A table alone cannot tell the full clinical picture.
| Parameter | Reference Range |
|---|---|
| Total Bilirubin at birth | Less than 5 mg/dL (85 μmol/L) |
| Total Bilirubin (day 3 to 5, term baby) | Up to 12 mg/dL (205 μmol/L) |
| Direct (Conjugated) Bilirubin | Less than 1.5 mg/dL (26 μmol/L) |
Normal bilirubin levels in newborns typically range from 1.0 to 12.0 mg/dL. In most cases, elevated bilirubin in newborns is predictable and resolves on its own.
These ranges are general guidelines. Your doctor will interpret your results based on your baby's age in hours, gestational age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Premature birth is a significant risk factor for increased bilirubin levels. Babies born before 37 weeks of gestation process bilirubin more slowly, feed less frequently, and pass fewer stools, which means less bilirubin is removed from the body.
Breastfed babies may be more likely to develop jaundice than formula-fed babies. Breastfeeding jaundice often occurs in the first week of life when a baby is not getting enough milk, which reduces the frequency of stools needed to clear bilirubin.
How to Maintain Healthy Levels
In many cases, bilirubin levels can be managed at home with the following measures.
- Feed your baby at least 8 to 12 times a day. Regular meals encourage bowel movements, which help the body eliminate bilirubin.
- Make sure your infant gets enough nourishment to support a healthy digestive system, whether it comes from formula or breast milk.
- Make sure your baby's bilirubin levels are constantly monitored during the early stages of life by attending all planned follow-up sessions with your paediatrician.
Lupin Diagnostics Neonatal Bilirubin Test Price and Home Collection
At Lupin Diagnostics, the neonatal bilirubin test starts at ₹150, with home sample collection available across major cities.
| City | Approximate Price (₹) |
|---|---|
| Mumbai | ₹200 |
| Pune | ₹200 |
| Hyderabad | ₹150 |
| Chennai | ₹190 |
| Bengaluru | ₹175 |
| Kolkata | ₹150 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Lupin Diagnostics offers home sample collection for the neonatal bilirubin test across multiple
cities, so your baby can be tested in the comfort of your home. A trained phlebotomist visits at your chosen time to safely and carefully collect the sample. All samples are processed in NABL-accredited laboratories, and digital reports are delivered directly to you.
FAQ on Neonatal Bilirubin (Neo-Bilirubin) Test
About 60% of full-term newborns and up to 80% of premature babies develop clinical jaundice in their first week of life. The neonatal bilirubin test helps doctors find babies whose bilirubin levels are rising quickly, so they can get the care they need when they need it.
The prick hurts for a short time, like a small pinch. Most babies cry for a little while, then calm down quickly when you hold or feed them. The whole thing only takes a few minutes.
When there is an emergency, neonatal bilirubin test results are usually ready in 3 hours. For
regular requests, reports are usually ready within a day. Lupin Diagnostics sends results by email or WhatsApp.
Jaundice is very common in babies and usually goes away on its own. In some cases, doctors may suggest phototherapy, a light-based treatment that helps break down bilirubin in the skin. Your doctor will tell you what to do next based on your baby's age and test results.
It is normal for newborns to have some degree of jaundice, and there is usually no way to prevent it. However, you can lower the risk of it getting worse by feeding your baby often, at least 8 to 12 times a day in the first few days. This can help the body get rid of bilirubin through the stools.
Speak to your baby's doctor if the yellowing appears to be getting worse, has not cleared up within two weeks, becomes difficult to wake up or feed your baby, or they seem unusually fussy. These signs mean you need to see a doctor right away.
No. A liver function test covers several markers to give a broad picture of liver health. The neonatal bilirubin test is a targeted test that specifically measures bilirubin to detect and monitor jaundice in newborns. It is not a replacement for a full liver function panel.
Neonatal Bilirubin (Neo-Bilirubin) Test
