Snapshot A healthy 2-week-old male presents with mild jaundice. He was born at term. Labs show a total billirubin of 18 mg/dl (normal <7 mg/dl), and a direct billirubin of 0.8 mg/dl (normal 0-0.4). Introduction Physiologic jaundice login to view 6 more bullets Pathologic jaundice login to view 10 more bullets Indirect (unconjugated) hyperbilirubinemia occurs in login to view 24 more bullets Conjugated (direct) hyperbilirubinemia occurs in login to view 7 more bullets Presentation Neonates may be jaundiced with bilirubin levels > 5 mg/dl Presents on physical exam with yellowish discoloration of the skin (progresses from head to toe with increasing bilirubin levels) and scleral icterus Billirubin levels rising above 9 are considered abnormal and need treatment Additionally, the presence of a factor listed above under "pathologic jaundice" always necessitates further work-up to determine a potential cause for the infant's jaundice STUDIES Blood smear login to view 1 more bullet Coombs' test login to view 5 more bullets LFTs, alk phos, bile acids, and sweat test login to view 2 more bullets Septic work-up login to view 1 more bullet Maternal-fetal ABO and Rh incompatibilites login to view 1 more bullet Differential Within 24 hoursHemolysis (ABO/Rh isoimmunization or hereiditary spherocytosis)Within 48 hoursHemolysisInfectionPhysiologicAfter 48 hoursInfectionHemolysisBreast MilkCongenital malformation (biliary atresia)Hepatitis Treatment Prevention login to view 3 more bullets Medical management login to view 7 more bullets Complications Retinal damage, dehydration, dermatitis, and diarrhea all related to UV exposure Prognosis Ranges widely Can spontaneously resolve or be fatal depending on etiology