Decreased bilirubin excretion Delay in intestinal transit time , because of decreased motility or bowel obstruction, increases the enterohepatic circulation. Relief of the obstruction results in a decline in bilirubin concentration. Crigler-Najjar syndrome is a rare, inherited, lifelong deficiency of bilirubin excretion. Type I is autosomal recessive. Type II is autosomal dominant, and it can effectively be treated with phenobarbital.
Neonatal hypothyroidism is another cause of prolonged indirect hyperbilirubinemia.
Sepsis often causes increased breakdown of red blood cells and decreased hepatic excretion of bilirubin. Certain drugs given to the newborn may also induce hemolysis or decrease bilirubin excretion. Breast feeding Feeding with breast milk is associated with neonatal hyperbilirubinemia. In healthy newborns, the danger of an elevated bilirubin concentration is minimal, and switching to formula feeding is unnecessary. Consequences of unconjugated hyperbilirubinemia.