Phototherapy for neonatal jaundice.

n engl j med 358;9 www.nejm.org february 28, 2008 920 A male infant weighing 3400 g was born at 37 weeks’ gestation after an uncomplicated pregnancy. The mother is a 24-year-old primipara who has type A Rh-positive blood. The infant’s course in the hospital nursery was uncomplicated. Although his mother needed considerable help in establishing effective breast-feeding, he was exclusively breast-fed. Jaundice was noted at the age of 34 hours. The total serum bilirubin level was 7.5 mg per deciliter (128 μmol per liter). The infant was discharged at the age of 40 hours and is seen in the pediatrician’s office 2 days later, now with marked jaundice. The results of his physical examination are otherwise normal, but his weight, at 3020 g, is 11% below his birth weight. His total serum bilirubin level is 19.5 mg per deciliter (333 μmol per liter), and his conjugated (direct) bilirubin level 0.6 mg per deciliter (10 μmol per liter). The complete blood count and peripheral-blood smear are normal. The infant has type A Rh-positive blood. The pediatrician consults a neonatologist regarding the need for phototherapy.