Neonatal Jaundice

Non-white M infant born at < 38 WGA via assisted vaginal delivery with h/o sepsis, cephalohematoma, and significant bruising presenting with neonatal jaundice. Infant exclusively breastfed. Maternal h/o GDM; familial h/o hemolytic anemia and neonatal jaundice. Birth weight > 3.5 kg; scleral icterus and yellow skin tone on exam.

• Obtain neonatal blood type (ABO incompatibility), direct antibody titer or Coombs test, CBC/smear, bilirubin levels

• Treatment

  • Start phototherapy pending labs

  • Exchange transfusion if bilirubin > 25 mg/dL

• Discuss adequacy of breasting feeding

  • Increase feedings to 12x per day

  • Provide reassurance to promote continued breastfeeding