Jaundice is such a common occurrence in the newborn that the physician is often consulted to delineate between what has been called "physiologic" jaundice and pathologic jaundice.
Diagnosis:
1. "Physiologic" jaundice appears between the 3rd and 10th day of life and total bilirubin value is under 12 mg/100 ml in term babies and under 15 mg/100 ml in pre- term babies.
2. "Pathologic" jaundice is diagnosed when the jaundice appears in the first 24 hours of life, cord bilirubin of 5 mg /100ml,a rise of bilirubin of 5 mg perday and when the total bilirubin is more than 12 mg/100 ml in term and 15 mg/100ml in pre-term babies and when the jaundice persists beyond the 10th day of life in term and 15th day of life in pre-term babies. On these instances etiologic diagnosis must be made.
3. Kernicterus is the clinical toxicity of bilirubin during neonatal period. The disorder is produced by deposition of fat-soluble bilirubin in the nuclear areas of the frequently affected sites. Diagnosis can be made by a thorough review of maternal history of drugs, blood group Rh, VDRL, Coombs test, peripheral blood smear of the baby. Physical examination, such as that displaying hepatosplenomegaly, is very important.
Treatment:
Phototherapy using either day light (white light) or blue light.
If jaundice is increasing, refer the child to the nearby zonal hospital.
