prolonged neonatal jaundice
Last reviewed 01/2018
Prolonged jaundice is defined as jaundice lasting for longer than:
- 14 days in term infants
- 21 days in preterm infants
The first investigation is to assay the proportion of conjugated bilirubin.
Possible causes include:
- urinary tract infection
- breast milk jaundice
NICE suggest (1) that in babies with a gestational age of 37 weeks or more with jaundice lasting more than 14 days, and in babies with a gestational age of less than 37 weeks and jaundice lasting more than 21 days:
- look for pale chalky stools and/or dark urine that stains the nappy
- measure the conjugated bilirubin
- carry out a full blood count
- carry out a blood group determination (mother and baby) and DAT (Coombs'
test). Interpret the result taking account of the strength of reaction, and
whether mother received prophylactic anti-D immunoglobulin during pregnancy
- carry out a urine culture
- ensure that routine metabolic screening (including screening for congenital hypothyroidism) has been performed.
Follow expert advice about care for babies with a conjugated bilirubin level greater than 25 micromol/litre because this may indicate serious liver disease
prolonged unconjugated neonatal jaundice