Physiologic Jaundice : A Part from The Book : Short Note: Neonatal Emergencies


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.

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