Newborn Hyperbilirubinemia Assessment
Assess jaundice severity and determine treatment needs based on Bhutani nomogram
Hyperbilirubinemia Assessment
Age at time of bilirubin measurement (12-168 hours)
Total serum bilirubin concentration
Input Validation Issues:
- • Infant must be at least 12 hours old for assessment
Example Assessment
Case: 3-Day-Old Full-Term Infant
Patient: 72-hour-old full-term infant (38 weeks GA)
Bilirubin: 16.5 mg/dL
Risk Factors: None present
Assessment Result
Phototherapy Threshold: ~15.0 mg/dL
Current Level: 16.5 mg/dL (above threshold)
Recommendation: Initiate phototherapy immediately
Follow-up: Repeat bilirubin in 4-6 hours
Types of Neonatal Jaundice
Physiologic Jaundice
Starts day 2-3, resolves by day 10-14
Normal process, usually benign
Pathologic Jaundice
Starts <24h or >14 days, abnormal levels
Requires investigation and treatment
Breast Milk Jaundice
Prolonged mild jaundice in breastfed infants
Usually harmless, can last months
Treatment Modalities
Phototherapy
Blue light (420-560nm) converts bilirubin to water-soluble form
Exchange Transfusion
Replace baby's blood to rapidly reduce bilirubin
IVIG
For isoimmune hemolysis (Rh disease)
Clinical Risk Factors
- G6PD deficiency
- ABO/Rh incompatibility
- Significant bruising/cephalohematoma
- Prematurity
- Poor feeding/dehydration
- Infection/sepsis
- Full-term, healthy infant
- Good feeding/hydration
- No risk factors
Understanding Neonatal Hyperbilirubinemia
What is Hyperbilirubinemia?
Hyperbilirubinemia is an elevated level of bilirubin in the blood, causing the yellow discoloration of skin and eyes known as jaundice. In newborns, this occurs due to immature liver function and increased breakdown of fetal hemoglobin.
Why is Monitoring Critical?
- •Prevents kernicterus (bilirubin brain damage)
- •Identifies pathological causes early
- •Guides timely treatment decisions
- •Prevents long-term neurological damage
Bhutani Nomogram
This calculator uses the Bhutani nomogram, endorsed by the American Academy of Pediatrics, to determine hour-specific bilirubin thresholds for phototherapy and exchange transfusion based on infant age and risk factors.
When to Seek Urgent Care
Immediate Medical Attention Required:
- Jaundice appearing in first 24 hours
- Rapidly rising bilirubin levels
- Bilirubin above exchange transfusion threshold
- Signs of kernicterus (lethargy, poor feeding, abnormal tone)
Critical Medical Disclaimer
This calculator is for educational and screening purposes only and should never replace professional medical evaluation. Neonatal hyperbilirubinemia can lead to serious neurological complications including kernicterus if not properly managed. Always consult with qualified pediatric healthcare professionals for assessment, diagnosis, and treatment decisions. Any infant with jaundice requires proper medical evaluation. This tool should only be used by trained healthcare professionals familiar with neonatal care guidelines.