Full-term, well-appearing neonates over 1 day of age often have physiologic or breast-milk jaundice.
Physiologic jaundice is benign. Bilirubin levels spike close to day 3 of life and then decrease. Breast-feeding jaundice may present in the first few days, before sufficient milk production, or may present later, for unknown reasons.
Breast-fed infants may have prolonged unconjugated hyperbilirubinemia lasting up to several weeks, thought to be related to compounds in breast-milk.
Unconjugated hyperbilirubinemia: Unconjugated hyperbilirubinemia causes include: physiologic jaundice, breast-milk jaundice, breast-feeding jaundice, hemolytic disease, blood group incompatibility, infection, dehydration, polycythemia, abnormalities in the conjugating enzyme (UDP-glucuronosyltransferase or UGT) as with Crigler–Najjar syndrome or Lucey–Driscoll syndrome, Gilbert syndrome, or hypothyroidism.
CBC, total bilirubin level, and direct bilirubin level should be obtained. A direct Coombs test should be obtained if maternal blood type is unknown, hemoglobin is low, or total bilirubin is at levels requiring intervention.
Author(s) Details:
Elsharif Ahmed Bazie,
Elimam Elmahdi University, Sudan.
Mona Isam El-Din Osman,
Sudan International University, Sudan.
