Clinical features of neonatal jaundice

In addition to the obvious icteric discolouration of the neonate, other clinical features may include:

• failure to thrive
• poor feeding
• other features of the underlying aetiology

NICE state that (1)

• identify babies as being more likely to develop significant hyperbilirubinaemia if they have any of the following factors:
  
  
  • gestational age under 38 weeks
  • a previous sibling with neonatal jaundice requiring phototherapy
  • mother's intention to breastfeed exclusively
  • visible jaundice in the first 24 hours of life
    
    
• in all babies:
  • check whether there are factors associated with an increased likelihood of developing significant hyperbilirubinaemia soon after birth
  • examine the baby for jaundice at every opportunity especially in the first 72 hours
    
    
• when looking for jaundice (visual inspection):
  • examine the sclerae and gums, and press lightly on the skin to check for signs of jaundice in 'blanched' skin
  • do not rely on visual inspection alone to estimate the bilirubin level in a baby with suspected jaundice

Reference:

• NICE (May 2016). Jaundice in newborn babies under 28 days - update.