Admit?
If below phototherapy threshold: Discharge
Inpatient rebound TsB measurement is not indicated unless:
Follow AAP Nomogram or Bilitool for phototherapy threshold.
>38wk: Repeat TsB is at least 2mg/dL below threshold?
<38wk: Repeat TsB is at least 5.5mg/dL below threshold?
Risk factors for severe hyperbilirubinemia:
Initial Assessment
Neurotoxicity risk factors:
Feeding during phototherapy:
If above phototherapy threshold, and within 2 mg/dl of exchange transfusion threshold:
Consult NICU, consider NICU admission
References:
1) John Muir Medical Center Neonatal Hyperbilirubinemia (internal document).
2) American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004; 114(1): 297–316.
3) American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks gestation. Pediatrics. 2011; 128(4): e1046-e1052.