Bilirubin (Total) Test

What is the total bilirubin test?

This is a blood test that measures the total amount of bilirubin in the blood. Bilirubin is released into the blood when red blood cells break down. The liver uses bilirubin to make bile.

Normally there is only a small amount of bilirubin in the blood. High levels may be caused by liver or blood problems. When the bilirubin level rises, it causes the skin and whites of the eyes to become yellow. This change to yellow is called jaundice.

Why is this test done?

This test may be done to:

• See how well your child’s liver is working, especially if your child has jaundice.
• Check for blockage of bile in the bile duct, gallbladder, or liver. Bile, which contains bilirubin, is normally released into the intestines through the bile duct. If the bile duct becomes blocked, or if there is blockage of bile in the gallbladder or liver, the bilirubin level rises in the blood since it is no longer released into the intestines.
• Check for certain blood problems, such as some types of anemia. Blood problems may cause a high level of bilirubin because more red blood cells are breaking down than normal.

How do I prepare my child for this test?

There is usually no special preparation for this test.

How is the test done?

For newborns, a blood sample is taken from the heel. For older children, a small amount of blood is taken from your child’s arm with a needle. The blood is collected in tubes and sent to a lab. Another test, called the transcutaneous bilirubin measurement, sends a quick flash of light through the skin over the breast bone.

Having this test will take just a few minutes. There is no risk of getting AIDS, hepatitis, or any other blood-borne disease from this test.

What does the test result mean?

The normal bilirubin range is 0 to 1.5 milligrams per deciliter (mg/dL) for children over the age of 1 month. For newborns, the normal range is 2.0 to 10.0 mg/dl. The normal range may vary slightly from lab to lab. Normal ranges are usually shown next to your child’s results in the lab report.

Your child’s level of bilirubin may be higher than normal because:

• Your child has Gilbert's syndrome, which causes slightly increased levels of bilirubin. Gilbert's syndrome is a harmless genetic condition that causes no symptoms other than mild jaundice.
• Your child is taking a medicine that raises the bilirubin level in your child’s blood.
• Your child has an infection.
• Your child has a liver or biliary tract disease, such as hepatitis or gallstones.
• Your child has a blood problem, such as anemia.

A bilirubin level lower than normal is, in general, never cause for concern.

What if my child’s test result is not normal?

Test results are only one part of a larger picture that takes into account your child’s medical history and current health. Sometimes a test needs to be repeated to check the first result. Talk to your child’s healthcare provider about your child’s result and ask questions.

If your child’s test result is not normal, ask your child’s healthcare provider:

• if your child needs additional tests
• what kind of treatment your child might need
• when your child needs to be tested again.