Paediatrics Search
Paediatrics Paediatrics
neonatal%20jaundice
NEONATAL JAUNDICE
Treatment Guideline Chart
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.

Neonatal Jaundice References

  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. Agency for Healthcare Research and Quality. Management of neonatal hyperbilirubinemia (summary). http://www.ahrq.gov/clinic/epcsums/neonatalsum.pdf. 2002
  7. Hansen TWR. Jaundice, neonatal. www.emedicine.medscape.com. Oct 2007
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. Ansong-Assoku B, Shah SD, Adnan M, et al. Neonatal Jaundice. National Library of Medicine. https://www.ncbi.nlm.nih.gov. 04 Jun 2022.
  14. BetterHealth. Jaundice in babies. Better Health Channel. https://www.betterhealth.vic.gov.au. 2019.
  15. Chee YY, Chung PHY, Wong RMS, et al. Jaundice in infants and children: causes, diagnosis and management. Hong Kong Medical Journal. 2018 Jun;24(3):285-292. doi: 10.12809/hkmj187245.
  16. Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med. 2001 Feb;344(8):581-590. doi: 10.1056/NEJM200102223440807. PMID: 11207355
  17. Dzulkifli FA, Mashor MY, Khalid K. Methods for Determining Bilirubin Level in Neonatal Jaundice Screening and Monitoring: A Literature Review. Journal of Engineering Research and Education. 2018;10.
  18. Erlichman J, Loomes KM. Biliary atresia. UpToDate. https://www.uptodate.com. 20 Jun 2022.
  19. Erlichman J, Loomes KM. Causes of cholestasis in neonates and young infants. UpToDate. https://www.uptodate.com. 19 Jan 2022.
  20. Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed. 2003 Jan;88(Suppl 1):F6-F10. doi: 10.1136/fn.88.1.f6. PMID: 12496219
  21. Govindarajan KK. Biliary atresia: where do we stand now?. World J Hepatol. 2016 Dec;8(36):1593-1601. doi: 10.4254/wjh.v8.i36.1593. PMID: 28083081
  22. Jackson A. Jaundice: neonatal guideline. NHS choices. https://www.clinicalguidelines.scot.nhs.uk. 13 Dec 2021.
  23. Lieberman L, Lopriore E, Baker JM, et al. International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn. Br J Haematol. 2022 Jul;198(1):183-195. doi: 10.1111/bjh.18170. PMID: 35415922
  24. Loomes KM, Erlichman J. Approach to evaluation of cholestasis in neonates and young infants. UpToDate. https://www.uptodate.com. 21 Jan 2021.
  25. Maisels MJ, Watchko JF, Bhutani VK, et al. An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation. J Perinatol. 2012 Sep;32(9):660-664. doi: 10.1038/jp.2012.71. PMID: 22678141
  26. Muchowski KE. Evaluation and treatment of neonatal hyperbilirubinemia. Am Fam Physician. 2014 Jun;89(11):873-878. PMID: 25077393
  27. National Institute for Health and Clinical Excellence (NICE). 2020 Surveillance review of jaundice in newborn babies under 28 days (NICE guideline CG98). NICE. https://www.nice.org.uk. 18 Jun 2010.
  28. Queensland Clinical Guidelines. Neonatal jaundice . Queensland Health. https://www.health.qld.gov.au. Jun 2019.
  29. Ranucci G, Della Corte C, Alberti D, et al. Diagnostic approach to neonatal and infantile cholestasis: a position paper by the SIGENP liver disease working group. Dig Liver Dis. 2022 Jan;54(1):40-53. doi: 10.1016/j.dld.2021.09.011. PMID: 34688573
  30. Riskin A, Tamir A, Kugelman A, et al. Is visual assessment of jaundice reliable as a screening tool to detect significant neonatal hyperbilirubinemia?. The Journal of Pediatrics. 2008;152(6). doi: 10.1016/j.jpeds.2007.11.003.
  31. Shaked O, Peña BM. Evaluation of jaundice caused by unconjugated hyperbilirubinemia in children. UpToDate. https://www.uptodate.com. 27 Jun 2022.
  32. Tan KL, Boey KW. Efficacy of phototherapy in non-haemolytic hyperbilirubinaemia. British Medical Journal. 1986 Nov;293(6558):1361-1363.
  33. Tang KS, Huang LT, Huang YH, et al. Gamma-glutamyl transferase in the diagnosis of biliary atresia. Acta Paediatr Taiwan. 2007 Aug;48(4):196-200. PMID: 18265540
  34. The Royal Children's Hospital Melbourne. Jaundice in early infancy . The Royal Children's Hospital Melbourne. https://www.rch.org.au. Oct 2020.
  35. Wan A, Mat Daud S, Teh SH, et al. Management of neonatal jaundice in primary care. Malays Fam Physician. 2016 Aug;11(2-3):16-19. PMID: 28461853
  36. Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in the newborn: pathogenesis and etiology. UpToDate. https://www.uptodate.com. 02 Dec 2021.
  37. Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants: management. UpToDate. https://www.uptodate.com. 02 Dec 2021.
  38. Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants: epidemiology and clinical manifestations. UpToDate. https://www.uptodate.com. 02 Dec 2021.
  39. Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants: screening. UpToDate. https://www.uptodate.com. 05 May 2022.
  40. Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in the newborn: interventions. UpToDate. https://www.uptodate.com. 10 Nov 2021.
  41. Wong RJ, Bhutani VK. Patient education: jaundice in newborn infants. UpToDate. https://www.uptodate.com. 01 Feb 2021.
  42. Zhang M, Tang J, He Y, et al. Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia. BMJ Open. 2021 Jan;11(1). doi: 10.1136/bmjopen-2020-040182.
Editor's Recommendations
Special Reports
MORE Special Reports arrow
Related Disease News
MORE Disease News arrow