–Phototherapy Chart.
–Differential diagnosis.
Red Flags Findings of Jaundice
The following findings are of particular concern:
- Jaundice in the first day of life
- TSB > 18 mg/dL
- Rate of rise of TSB > 0.2 mg/dL/h or > 5 mg/dL/day
- Conjugated bilirubin concentration > 1 mg/dL if TSB is < 5 mg/dL or > 20% of TSB (suggests neonatal cholestasis)
- Jaundice after 2 wk of age
- Lethargy, irritability, respiratory distress
Key points
- “Physiologic jaundice in healthy term newborns follows a typical pattern. The average total serum bilirubin level usually peaks at 5 to 6 mg per dL (86 to 103 μ mol per L) on the third to fourth day of life and then declines over the first week after birth.” AAFP 2002
Further Reading
J Perinatol. 2010 Oct;30 Suppl:S6-15. Universal bilirubin screening for severe neonatal hyperbilirubinemia.
Am Fam Physician. 2014 Jun 1;89(11):873-878. Evaluation and Treatment of Neonatal Hyperbilirubinemia. https://www.aafp.org/afp/2014/0601/p873.html
https://www.merckmanuals.com/professional/pediatrics/metabolic,-electrolyte,-and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia