JAUNDICED NEWBORN

Definition

Types of Jaundice

Physiological jaundice (50% of newborns)

Breastfeeding jaundice(5 to 10% of newborns)

Breastmilk jaundice (1% of newborns)

Rh and ABO blood group incompatibility


WHEN TO CALL YOUR DOCTOR

Call 911 now (your child may need an ambulance) if:

Call your doctor now (night or day) if:

Call your doctor within 24 hours (between 9am and 4pm) if:

Call your doctor during weekday office hours if:

Parent care at home if:


HOME CARE ADVICE

  1. Bottlefed: If bottle fed, increase the frequency of feedings. Try for an interval of every 2 to 3 hours during the day.
  2. Breastfed: If breastfed, increase the frequency of feedings. Nurse your baby every 1 1/2 to 2 1/2 hours during the day. Don't let your baby sleep more than 4 hours at night without a feeding.
  3. Increase Stools:
    • If your baby is 5 days or older AND has less than 3 stools/day, carefully insert a lubricated thermometer 1/2 inch (12 mm) into the anus and gently move it from side to side a few times to stimulate a stool.
    • Reason: increased stools carry more bilirubin out of the body
    • Do this once or twice per day until jaundice improves or stool frequency becomes normal.
  4. Expected Course: Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
  5. Judging Jaundice:
    • View your baby unclothed in natural light near a window.
    • Press on the yellow skin on the chest with a finger to remove the normal skin tone.
    • Then assess the jaundice color before the pink color returns.
  6. Call Your Doctor If:
    • Jaundice not gone by day 14
    • Your baby is not getting enough milk (needs a weight check)
    • Your baby starts to act sick
    • Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.


REFERENCES

  1. American Academy of Pediatrics, Provisional Committee for Quality Improvement. Practice parameter: management of hyperbilirubinemia in the healthy term newborn. Pediatrics. 1994;94:558-565.
  2. American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. Clinical Practice Guideline: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114(1):297-316.
  3. American Academy of Pediatrics, Subcommittee on Neonatal Hyperbilirubinemia Neonatal jaundice and kernicterus. Pediatrics. 2001;108:763-764.
  4. Bhutani V, Johnson L and Keren R. Treating acute bilirubin encephalopathy-before it’s too late. Contemp Pediatr. 2005;22(5):57-74.
  5. Chiu A. Unconjugated hyperbilirubinemia. In: Moyer V, Davis RL, Elliott E, et al, eds. Evidence Based Pediatrics and Child Health. London, England: BMJ Publishing Group; 2000. p. 306-312.
  6. Dixit R and Gartner LM. The jaundiced newborn: Minimizing the risks. Contemp Pediatr. 1999;16(4):166-183.
  7. Gartner LM, Herrarias CT, Sebring RH. Practice patterns in neonatal hyperbilirubinemia. Pediatrics. 1998;101:25-31.
  8. Gartner LM. Neonatal jaundice. Pediatr Rev. 1994;15:422-432.
  9. Maisels MJ. Neonatal jaundice. Pediatr Rev. 2006;27(12):443-454.
  10. Maisels MJ. Jaundice in a newborn. Contemp Pediatr. 2005;22(5):34-54.
  11. Moyer VA, Ahn C, Sneed S. Accuracy of clinical judgment in neonatal jaundice. Arch Pediatr Adolesc Med. 2000;154:391-394.
  12. Palmer HR, Clanton M, Ezhuthachan S, et al. Applying the 10 simple rules of the institute of medicine to management of hyperbilirubinemia in newborns. Pediatrics.. 2003;112(6):1388-1393.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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