Gastroenterology Book

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Neonatal Bilirubin

Aka: Neonatal Bilirubin, Bilirubin in Newborns
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  1. See Also
    1. Bilirubin
    2. Neonatal Jaundice
    3. Neonatal Jaundice Causes
    4. Phototherapy
    5. Liver Function Test
    6. Liver Function Test Abnormality
  2. Resources
    1. Bilirubin Tool
      1. http://www.bilitool.com
  3. Interpretation: Risk of Hyperbilirubinemia in term infants
    1. Age 24 hours of life
      1. Low risk: Bilirubin <5 mg/dl
      2. High risk: Bilirubin >8 mg/dl
    2. Age 48 hours of life
      1. Low risk: Bilirubin <8 mg/dl
      2. High risk: Bilirubin >13 mg/dl
    3. Age 72 hours of life
      1. Low risk: Bilirubin <11 mg/dl
      2. High risk: Bilirubin >16 mg/dl
    4. Age 96 hours of life
      1. Low risk: Bilirubin <12 mg/dl
      2. High risk: Bilirubin >18 mg/dl
  4. Interpretation: Normal Total Bilirubin in Newborns
    1. General
      1. Normal Increase <5 mg/dl/day (<0.5 mg/dl/hour)
      2. Conjugated Bilirubin (Direct) fraction <2 mg/dl
    2. Term Infant
      1. Peaks: 12.9 at 3 to 4 days of life
      2. Resolves at 4 to 7 days of life
    3. Preterm Infant
      1. Peaks: 15.0 at 5 to 7 days
      2. Resolves at 10 to 14 days of life
    4. Exagerated Physiologic Jaundice
      1. Peaks 17.0 at age 6 to 8 days of life
    5. Early-Onset Breast Milk Jaundice
      1. Same course as exaggerated physiologic Jaundice
      2. Total Bilirubin peaks < 17 mg/dl by day 4 of life
    6. Late-Onset Breast Milk Jaundice
      1. Bilirubin peaks between day of life 6 to 14 of life
      2. Total Bilirubin often 12 to 20 mg/dl
      3. Hyperbilirubinemia may persist 2-3 months
  5. References
    1. Bhutani (1999) Pediatrics 103:6-14

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