Consult neonatologist
Admit to NICU. Continue to encourage feeding. Do not be remove the patient from bili lights for > 20 mins in any 3 hour period.
Meets discharge criteria?
Treat appropriately
Discharge
IV fluids are not routinely necessary in well appear patients with hyperbilirubinema
High risk factors for severe hyperbilirubinemia
Low risk factors for hyperbilirubinemia
Neurotoxicity risk factors
Any of the following features present?
Continue to encourage feeding. Do not be remove the patient from bili lights for > 20 mins in any 3 hour period.
Discontinue phototherapy when TSB is at least 3 mg/dL below the phototherapy initiation threashold.
Subsequent bili checks as clinically indicated. Discontinue phototherapy when TSB is at least 3 mg/dL below the phototherapy initiation threashold.
Rebound TSB is not usually necessary prior to discharge
Possible needs for a longer course of phototherapy
Discharge criteria
Transcutaneous bilirubin may vary based on racial and other factors and requires confirmatory serum testing
AAP Phototherapy Thresholds
Evaluate factors for acute bilirubin encephalopathy
Phothotherapy MAY be a risk factor for childhood cancer (although more study is needed in this area) so the treatment should be avoided in neonates who are not at high risk.