Significant Jaundice over 10 days of age
Physiological jaundice tends to reach peak levels between 4 and 7 days in full term babies and 7-10 days in the pre-term (depending on gestational age). It is not unusual for babies to still be visually icteric at 2 weeks of age especially if they are breast fed. Infants with prolonged jaundice are usually well and all that is required is to check the total and direct reacting bilirubin and ensure potentially toxic levels are not exceeded.
Babies from the community with prolonged jaundice at 14 days will go to the prolonged jaundice clinic in Fielden House run by the ambulatory paediatricians. For babies still under our care, check:
- direct bilirubin (if >= 20% of the total bilirubin then please see conjugated hyperbilirubinaemia algorithm)
- TSH, T4,
- FBC, reticulocytes, film
- Group, DCT
- G6PD
In the preterm infant a prolonged jaundice screen should be performed at 21 days of age.
