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Neonatal Jaundice — RACP Paediatrics MCQ

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ModerateNeonatologyNeonatal JaundiceRACP Paediatrics

A 3-day-old term breastfed infant has a total serum bilirubin of 380 μmol/L. He is clinically jaundiced to the soles. Direct Coombs is negative. What is the most important immediate management?

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Correct answer: C — Commence intensive phototherapy immediately

A TSB of 380 μmol/L at 72 hours in a term infant exceeds the phototherapy threshold and requires immediate intensive phototherapy. The 2022 AAP guidelines provide hour-specific thresholds. If the TSB is approaching the exchange transfusion threshold, exchange transfusion should be prepared. Breastfeeding should be continued. Interruption of breastfeeding is not recommended.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Jaundice in Early Infancy