Jaundice, Neonatal
Description Diagnostic criteria Breastfeeding associated jaundice ICD-10 code: P58 DESCRIPTION Yellow discolouration of the skin and mucous membranes due to hyperbilirubinaemia. Bilirubin is formed mainly from haem catabolism. Jaundice develops when there is an overproduction of bilirubin, defective bilirubin metabolism and/or defective excretion of bilirubin from the body. DIAGNOSTIC CRITE
Description
Diagnostic criteria
Breastfeeding associated jaundice
ICD-10 code: P58
DESCRIPTION
Yellow discolouration of the skin and mucous membranes due to hyperbilirubinaemia. Bilirubin is formed mainly from haem catabolism. Jaundice develops when there is an overproduction of bilirubin, defective bilirubin metabolism and/or defective excretion of bilirubin from the body.
DIAGNOSTIC CRITERIA
Jaundice may be physiological or pathological.
Physiological jaundice
- Seldom appears before 24–36 hours after birth.
- Rarely lasts more than 10 days in the full term infant and 14 days in the preterm infant.
- Only the unconjugated bilirubin fraction is increased.
- Total peak serum bilirubin concentration is usually below 275 µmol/L in the term infant.
- Total bilirubin concentration does not rise by more than 85 µmol/L/24 hours or 17 µmol/L/hour.
- The baby thrives and shows no signs of illness or anaemia.
- Treatment is unnecessary.
Pathological jaundice
- May appear within the first 24 hours of birth, but can occur at any time after birth.
- Persists for longer than 14 days in the full term infant or 21 days in the preterm infant.
- The unconjugated and/or conjugated fractions of bilirubin are increased.
- The conjugated bilirubin level exceeds 20% of the total bilirubin value, or the conjugated bilirubin fraction is 30 µmol/L or more.
- Total bilirubin concentration rises by more than 85 µmol/L/24 hours or 17 µmol/L/hour and the total serum bilirubin level is above physiological level.
- There are signs and symptoms of illness in the baby.
- Stools are pale in obstructive jaundice.
BREASTFEEDING ASSOCIATED JAUNDICE
Increased unconjugated bilirubin levels during the first week of life in breastfed babies is due to calorie and fluid deprivation and delayed passage of stools. It improves with increased frequency of breastfeeding.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 19: Prematurity And Neonatal Conditions, 19.2 Newborn, 19.2.1 Jaundice, Neonatal
Click here for 19.2.1.1 Hyperbilirubinaemia, Unconjugated
Click here for 19.2.1.2 Hyperbilirubinaemia, Conjugated
Click here for 19.2.1.3 Jaundice, Neonatal, Prolonged