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American Academy of Pediatrics
Article

Jaundice in the Healthy Newborn Infant: A New Approach to an Old Problem

M. Jeffrey Maisels, Kathleen Gifford, Charles E. Antle and Gregory R. Leib
Pediatrics April 1988, 81 (4) 505-511;
M. Jeffrey Maisels
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Kathleen Gifford
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Charles E. Antle
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Gregory R. Leib
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Abstract

We measured the serum bilirubin concentrations in 2,416 consecutive infants admitted to our well baby nursery. The maximal serum bilirubin concentration exceeded 12.9 mg/dL (221 µmol/L) in 147 infants (6.1%), and these infants were compared with 147 randomly selected control infants with maximal serum bilirubin levels ≤12.9 mg/dL. A serum bilirubin concentration >12.9 mg/dL was associated strongly with breast-feeding (P = .0000) and percentage of weight loss after birth (P = .0001), as well as with maternal diabetes, oriental race, decreased gestational age, male sex, bruising, and induction of labor with oxytocin. Risk ratios and the risk of jaundice were calculated for hypothetical infants in the presence and absence of these variables. These calculations show that, in certain infants, "nonphysiologic" jaundice is likely to develop and its presence in such infants might not require laboratory investigations. In others, a modest degree of hyperbilirubinemia could be cause for concern. An awareness of these factors and their potential contribution to serum bilirubin levels permits a more rational approach to the action levels used for the investigation of jaundice in the newborn. We need a new definition of physiologic jaundice.

  • jaundice
  • hyperbilirubinemia
  • bilirubin
  • newborn infant
  • breast-feeding
  • Received August 4, 1986.
  • Accepted July 6, 1987.
  • Copyright © 1988 by the American Academy of Pediatrics

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Pediatrics
Vol. 81, Issue 4
1 Apr 1988
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Jaundice in the Healthy Newborn Infant: A New Approach to an Old Problem
M. Jeffrey Maisels, Kathleen Gifford, Charles E. Antle, Gregory R. Leib
Pediatrics Apr 1988, 81 (4) 505-511;

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Jaundice in the Healthy Newborn Infant: A New Approach to an Old Problem
M. Jeffrey Maisels, Kathleen Gifford, Charles E. Antle, Gregory R. Leib
Pediatrics Apr 1988, 81 (4) 505-511;
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Cited By...

  • Beyond "Asian": Specific East and Southeast Asian Races or Ethnicities Associated With Jaundice Readmission
  • Early Discharge of Infants and Risk of Readmission for Jaundice
  • Excess Weight Loss in First-Born Breastfed Newborns Relates to Maternal Intrapartum Fluid Balance
  • Reference chart for relative weight change to detect hypernatraemic dehydration
  • Preventable Newborn Readmissions Since Passage of the Newborns' and Mothers' Health Protection Act
  • The Contribution of Hemolysis to Early Jaundice in Normal Newborns
  • Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
  • Postnatal weight loss in term infants: what is "normal" and do growth charts allow for it?
  • Incidence, Course, and Prediction of Hyperbilirubinemia in Near-Term and Term Newborns
  • Neonatal weight loss in breast and formula fed infants
  • Risk Factors for Suboptimal Infant Breastfeeding Behavior, Delayed Onset of Lactation, and Excess Neonatal Weight Loss
  • Is Breastfeeding Really Favoring Early Neonatal Jaundice?
  • Breastfeeding, Diet, and Neonatal Hyperbilirubinemia
  • Length of Stay, Jaundice, and Hospital Readmission
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