neonatal%20jaundice
NEONATAL JAUNDICE
Jaundice that appears in a newborn <24 hour old is most likely nonphysiologic and needs further evaluation.
Jaundice typically presents on the 2nd-3rd day of life. It is usually first seen on the face and forehead then progresses caudally to the trunk and extremities.
Visible jaundice in the feet may be an indication to check bilirubin level.
Visual estimation of bilirubin level is often inaccurate and unreliable.
Danger signs in a newborn infant with jaundice includes changes in brainstem evoked auditory potentials, changes in muscle tone, seizures and altered cry characteristics.
The presence of any of the danger signs require prompt attention to prevent kernicterus.
  1. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 weeks or more of gestation. Pediatr. 2004 Jul;114(1):297-316. http://pediatrics.aappublications.org/content/114/1/297.full.pdf. PMID: 15231951
  2. Ip S, Chung M, Kulig J, et al. An evidence-based review of important issues concerning neonatal hyperbilirubinemia. Pediatrics. 2004 Jul;114(1):e130-316. PMID: 15231986
  3. Riskin A, Tamir A, Kugelman A, et al. Is visual assessment of jaundice reliable as a screening tool to detect significant neonatal hyperbilirubinemia?. J Pediatr. 2008 Jun;152(6):782-787. doi: 10.1016/j.jpeds.2007.11.003. PMID: 18492516
  4. Moerschel SK, Cianciaruso LB, Tracy LR. A practical approach to neonatal jaundice. Am Fam Physician. 2008 May;77(9):1255-1262. PMID: 18540490
  5. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  6. Ministry of Health Malaysia. Clinical practice guidelines: management of jaundice in healthy term newborns. http://www.moh.gov.my/. Feb 2003
  7. Agency for Healthcare Research and Quality. Management of neonatal hyperbilirubinemia (summary). http://www.ahrq.gov/clinic/epcsums/neonatalsum.pdf. 2002
  8. Hansen TWR. Jaundice, neonatal. www.emedicine.medscape.com. Oct 2007
  9. National Institute for Health and Clinical Excellence. Clinical guidance 98 neonatal jaundice: full guideline. NICE website. https://www.nice.org.uk/guidance/cg98/resources/guidance-neonatal-jaundice-pdf. May 2010.
  10. Ministry of Health Malaysia. Clinical practice guidelines: management of neonatal jaundice. 2nd ed. Malaysia Health Technology Assessment Section (MaHTAS): Ministry of Health Malaysia; 2014 Dec. http://www.moh.gov.my/penerbitan/CPG/CPG%20Management%20of%20Neonatal%20Jaundice%20(Second%20Edition).pdf.
  11. Wong RJ, Bhutani VK. Treatment of unconjugated hyperbilirubinemia in term and late preterm infants. UptoDate website. http://www.uptodate.com/contents/treatment-of-unconjugated-hyperbilirubinemia-in-term-and-late-preterm-infants. Sep 2015.
  12. Bhutani VK, Wong RJ. Hyperbilirubinemia in the premature infant (less than 35 weeks gestation). UptoDate website. http://www.uptodate.com/contents/hyperbilirubinemia-in-the-premature-infant-less-than-35-weeks-gestation. Oct 2015.
  13. Ministry of Health Malaysia. Clinical practice guidelines: management of neonatal jaundice (second edition). Ministry of Health Malaysia Web Site. http://www.moh.gov.my/penerbitan/CPG/CPG%20Management%20of%20Neonatal%20Jaundice%20(Second%20Edition).pdf. 2015.
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