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.

Supportive Therapy

Nutrition

  • If possible, breastfeeding should be continued
    • Optimal breastfeeding 8-12 times per day increases removal of bilirubin through the gastrointestinal tract
    • Supplemental breast milk or formula may be given to infants with insufficient oral intake, dehydration or excessive weight loss
  • Hydration
    • Adequacy of oral intake should be evaluated in an infant who lost >10% of birth weight
    • Infant should be referred to a specialist if with weight loss of >7% of birth weight & for close monitoring for severe hyperbilirubinemia
    • If infant’s oral intake is unreliable, give IV fluids
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