Jaundice: Newborn to age 2 months

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Abstract

On the basis of moderate research and American Academy of Pediatrics guidelines, universal screening with bilirubin measurements, combined with risk factor assessment, can improve outcomes of newborns with unconjugated hyperbilirubinemia. The bilirubin nomogram results can guide clinicians in determining low-, intermediate-, and high-risk zones of hyperbilirubinemia according to postnatal age in hours. 2. On the basis of strong research, prompt diagnosis and proper management of severe, unconjugated hyperbilirubinemia are critical to prevent acute bilirubin encephalopathy and kernicterus. 3. On the basis of moderate research, there are differences in the presentation and management of breastfeeding and breast milk jaundice. 4. On the basis of strong research, biliary atresia is the most common cause of cholestasis in infants younger than 2 months of age. The stool color is an important part of the initial evaluation in infants with cholestasis, and pale or acholic stool is highly suspicious for biliary atresia or other biliary obstruction. Early referral to a subspecialist is important to improve outcome. 5. On the basis of moderate research and consensus, gestational alloimmune liver disease (GALD) is a rare neonatal condition with early onset of cholestasis during the first week after birth. Intravenous immunoglobulin should be given as soon as possible in newborns with suspected GALD to decrease the risk of mortality. 6. On the basis of strong research, malabsorption of fat and fatsoluble vitamins is common in patients with cholestasis. It is essential to provide supplementation with medium-chain triglyceride oil and fat-soluble vitamins and to closely monitor serum vitamin levels.

Original languageEnglish (US)
Pages (from-to)499-510
Number of pages12
JournalPediatrics in Review
Volume38
Issue number11
DOIs
Publication statusPublished - Nov 1 2017

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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