Dawaa Reference

chronic

Physiological Neonatal Jaundice

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources. · AAP Clinical Practice Guideline: Management of Hyperbilirubinemia in Newborn Infant 2022

Verified against1 document
  • Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (9)

  • History: pregnancy problems, family history, the delivery, when symptoms began, how feeding is going, maternal serology
  • The colour of stool and urine hints at which type of jaundice [jaundice]
  • Yellowing showing up within the first 24 hours after birth is a major risk factor
  • A bilirubin already sitting in the high-risk zone before going home is a major risk factor
  • Blood group incompatibility between mother and baby, or a gestation <36 weeks
  • A close relative who needed phototherapy, cephalhaematoma or heavy bruising, exclusive breastfeeding, Asian origin [bruising]
  • Lesser risks: bilirubin in the high-intermediate band, a big baby of a diabetic mother, polycythaemia, male sex, mother over 25
  • Look for bilirubin encephalopathy: feeding poorly, lethargy, disturbed sleep, abnormal tone, fits [kernicterus · lethargy · poor feeding · seizures]
  • Up to 15% of babies with kernicterus show nothing at all in the newborn weeks [kernicterus]

Signs — what you find (4)

  • Examine in daylight, but judging it by eye is unreliable, more so after phototherapy or with dark skin
  • Confirm any jaundice that matters with a serum or transcutaneous bilirubin [jaundice]
  • Pointers to a pathological cause: pallor, petechiae, cephalhaematoma, heavy bruising, big liver and spleen, weight loss, dehydration [bruising · dehydration · pallor · petechiae · weight loss]
  • Yellow skin and whites of the eyes in a newborn is jaundice [jaundice]

Tests (12)

  • Every newborn should be looked at for jaundice every 12 hours until discharge
  • Measure bilirubin between 24 and 48 hours of age, or before discharge if the baby leaves sooner
  • Transcutaneous bilirubin screens and spares blood tests, but is less use with dark skin or after phototherapy
  • Send a serum bilirubin once the transcutaneous reading passes the 95th percentile on its nomogram, or 75% of the phototherapy threshold
  • Transcutaneous testing cannot read the direct fraction, so it cannot diagnose cholestasis
  • For haemolysis: mother and baby blood groups, direct antibody test, blood count, reticulocytes, film, G6PD
  • Imaging is usually unnecessary for unconjugated hyperbilirubinaemia
  • With conjugated bilirubin, transaminases show liver cell damage, and a raised ALP or GGT points to blocked bile ducts
  • PT, INR and albumin gauge how well the liver is working
  • Liver ultrasound finds sludge in the bile ducts, stones, thickened bile and choledochal cysts
  • A triangular cord sign on ultrasound is close to 100% specific for biliary atresia
  • Further tests: TORCH titres, urine and viral cultures, newborn screening, metabolic disease, alpha-1 antitrypsin phenotype, genetics

If not this — what else fits (4)

  • Jaundice appearing needs prompt sorting into a self-limiting physiological one or a disease needing treatment
  • Carotene from breast milk or carotene-rich food yellows the skin of older infants and can pass for jaundice
  • In carotenaemia the whites of the eyes and the mucosa stay clear, and no newborn is born with it
  • Cholestasis in a newborn usually touches several systems, which steers the workup

SourceStatPearls "Neonatal Jaundice" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY REQUIRED

1st line
Adult dose and duration

None - supportive care only x 7-10 days

Paediatric dose

Encourage frequent breastfeeding every 2-3 hours (8-12 feeds/24h). Monitor transcutaneous or serum bilirubin

Dose source

Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources.

Why

Frequent breastfeeding (8-12 times daily) is the primary intervention for physiological neonatal jaundice; no drug therapy required

Cautions
  • Routine IV fluids not indicated; encourage frequent breastfeeding (8-12 feeds/24h) and monitor bilirubin.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.