What are the indications for referring a newborn with jaundice to a specialist?

Refer a newborn with jaundice to a specialist if there is suspected or obvious jaundice in the first 24 hours of life and urgent medical review is needed to exclude pathological causes of jaundice ¹.

Refer if the serum bilirubin level is above the treatment threshold according to postnatal age in hours, or if the bilirubin level is rising rapidly or exceeds the threshold for intervention ¹.

Refer if the baby has a conjugated bilirubin level greater than 25 micromol/litre, which may indicate serious liver disease ¹.

Refer if there are clinical signs of acute bilirubin encephalopathy or if the serum bilirubin level is greater than 340 micromol/litre in babies with a gestational age of 37 weeks or more, or if there is a rapidly rising bilirubin level of more than 8.5 micromol/litre per hour ¹.

Refer if there are signs of underlying disease such as pale chalky stools, dark urine, or if routine metabolic screening indicates abnormalities ¹.