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Newborn and Infant Care

Jaundice

07/27/2009

Question:

my daughter is 92 hours old and has a jaundice level of 14. she is under home phototherapy. I have O+ blood and she has A+ blood. what is a normal/(safe) level that she should have at this time. And when should we really start to worry? her Dr. Says keep her on the the light and not to worry at this time. Im scared to death! please help

Answer:

There is a fair amount of debate in the medical literature as to what bilirubin value is worrisome and what level is acceptable. There are differences in peak newborn bilirubin levels which depend upon age (in hours), sex, birth order, ethnicity, and some feel your geographic area. The American Academy of pediatric, in general, recommend that bilirubin levels < 15 be monitored and those > that 15 be treated with phototherapy. If you are breast feeding the recommendation is to continue throughout this period. I am not listing all the boundaries for treatment here, so, if your health care provider varies, you are still receiving good care. This is a VERY common condition and the most common reason is ABO (blood type) incompatibility. Keeping in touch with your health care provider and obtaining blood work as requested cannot be over emphasized.

Reference: Maizels, M.J. (2006). What's in a name? Physiologic and pathologic jaundice: The conundrum of defining normal bilirubin levels in the newborn. Pediatrics, 118, 815-807.

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Response by:

Sarah Sauntry, RN, MS, CPNP-PC
Assistant Professor of Clinical Nursing
College of Nursing
University of Cincinnati