Breast Milk<unk> 
Do not need to routinely stop breast-feeding
If bilirubin elevated beyond 10 mg/dL:
Stop feeding for 1-2 days, substitute with bottle, and then resume breast milk
Recurrence of prior hyperbilirubinemia is uncommon upon resuming
Treat with phototherapy when levels exceed 20 mg/dL
Breast-Feeding<unk>  (Starvation<unk> 
Supplement with expressed breast milk or formula
Exchange transfusion
Consider if signs of bilirubin encephalopathy, typically only occurs when the indirect bili level exceeds 25
Hypertonia, arching, retrocollis, opisthotonos
Direct hyperbilirubinemia
If new diagnosis, always admit to the hospital for further evaluation
Do not need to routinely stop breast-feeding
If bilirubin elevated beyond 10 mg/dL:
Stop feeding for 1-2 days, substitute with bottle, and then resume breast milk
Recurrence of prior hyperbilirubinemia is uncommon upon resuming
Treat with phototherapy when levels exceed 20 mg/dL
Stop feeding for 1-2 days, substitute with bottle, and then resume breast milk
Recurrence of prior hyperbilirubinemia is uncommon upon resuming
Supplement with expressed breast milk or formula
Consider if signs of bilirubin encephalopathy, typically only occurs when the indirect bili level exceeds 25
Hypertonia, arching, retrocollis, opisthotonos
Hypertonia, arching, retrocollis, opisthotonos
If new diagnosis, always admit to the hospital for further evaluation
14.5
Low Risk: ≥38 weeks + no risk factors
Medium Risk: (≥38 weeks + risk factors) or (35-37 weeks and no risk factors)
High Risk: 35-37 weeks + risk factors
Neonatal jaundice
More common causes are listed first, followed by less common causes
Breast milk jaundice
Breast feeding jaundice
Due to substances in milk that inhibits glucuronyl transferase. It may start as early as 3rd day and reaches peak by 3rd week of life. It is unlikely to cause kernicterus
Biliary atresia
Neonatal hypoglycemia
Patient does not receive adequate oral intake which then causes reduced bowel movement/bilirubin excretion. Best diagnosed by looking for signs of dehydration and comparing weight to birth weight.