Jaundice of the newborn; Neonatal hyperbilirubinemia
The main symptom is a yellow color of the skin. The yellow color is best seen right after gently pressing a finger onto the skin. The color sometimes begins on the face and then moves down to the chest, belly area, legs, and soles of the feet.
Sometimes, infants with significant jaundice have extreme tiredness and poor feeding.
All newborns should be examined for jaundice at least every 8 to 12 hours for the first day of life.
Any infant who appears jaundiced in the first 24 hours should have bilirubin levels measured immediately. This can be done with a skin or blood test.
Babies should be assigned a risk for later developing jaundice before they leave the hospital. Doctors use hourly bilirubin levels to predict a babyâ ' s odds of later developing jaundice. Babies are classified as low risk , low intermediate risk, high intermediate risk, or high risk. Many hospitals do this by routinely checking total bilirubin levels on all babies at about 24 hours of age.
Further testing varies on the infant's specific situation and test results. For example, the possible cause of the jaundice should be sought for babies who require treatment or whose total bilirubin levels are rising more rapidly than expected.
Tests that will likely be done include:
Serum albumin levels may also be checked. Because bilirubin travels in the blood attached to albumin when possible, low albumin levels may increase the risk of damage from excessive jaundice.
American Academy of Pediatrics (AAP). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297-316.
Mercier CE, Barry SE, Paul K, et al. Improving Newborn Preventive Services at the Birth Hospitalization: A Collaborative, Hospital-Based Quality-Improvement Project. Pediatrics. 2007 Sep;120(3):481-488.
Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999 Jan;103(1):6-14.