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Newborn Jaundice: Bilirubin 16.3
Hello Doctors,
My son had mild jaundice when he was discharged on Day 4. The doctor recommended 3 hours of phototherapy, after which his bilirubin level came down to normal.
Now, on Day 11, his bilirubin level is 16.3 mg/dL. His eyes are mildly yellow, but there are no other noticeable symptoms. He is feeding regularly.
Our doctor has advised us to continue regular feeding and said that phototherapy is not required unless the bilirubin reaches 20 mg/dL.
I would like to get a second opinion:
Is it safe to wait and monitor at this level?
Should we repeat the bilirubin test after a certain number of days?
Are there any warning signs we should watch for?
Thank you.
Answers (10)
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Dr Faisal Zoheb
MBBS , MD PAEDIATRICS , PGPN (BOSTON), FELLOWSHIP IN NEONATOLOGY ( Newborn and vaccination specialist )
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In a healthy term infant ≥38 weeks, 16.3 mg/dL at around 11 days is often below the phototherapy threshold, If the baby is well, feeding adequately, gaining weight, and has no risk factors, no immediate phototherapy Is required.
* A few causes of prolonged jaundice could be breastfeeding/insufficient intake, breast-milk jaundice, hypothyroidism, infection, few other causes etc.
Urgent assessment is needed if there is poor feeding, lethargy, abnormal cry, hypotonia/hypertonia, fever, worsening jaundice, or reduced urine output, high coloured urine, pale stools.
Consult your paediatrician and if required you can get a retest after 2 weeks.
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hello,i'm Dr lasya,pediatrician.
yellowish discoloration of eyes starts at even 2mg/dl and it takes around 2 weeks for total bilirubin to come to normal levels.there will be cut off values for each day of life.If your baby is a 37 or more than 37 week born baby without any risk factors and your baby doesnt fit into phototherapy criteria so need to worry.
Next Steps
feed the baby regularly and check for weight gain(30g/day)
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Consult on Practo
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Dr. Ankita Gahlot
Obstetrician
12 yrs exp
Bangalore
Mild jaundice that's improving with normal feeding is usually reassuring at this stage, but the exact bilirubin cutoff and repeat testing schedule should stay with your pediatrician who's already tracking the trend.
Next Steps
Watch for your baby feeding poorly, being unusually sleepy, or the yellow color spreading to the arms and legs.
Health Tips
If any of those appear, please have your baby seen the same day rather than waiting for the scheduled repeat test.
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Dr. Jay Gajjar
Pediatrician
6 yrs exp
Surat
It is safe
Sos follow up if not feeding properly, lethargic, yellow discolouration increases
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Dr. Mahak Arora
Pediatrician
10 yrs exp
New Delhi
At the age of 11 days the mentioned value of bilirubin is what you have nothing to worry for . continue breast feeding along with watch for danger sign ( lethargic, dull , not feeding well, high pitch cry, irritable)
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Dr. Tangade Vishal Bhanudas
Pediatrician
4 yrs exp
Pune
Visit physically to nearby pediatrician or consult online.
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Dr. Bhatt Vivek Prafulchandra
Pediatrician
5 yrs exp
Rajkot
Consult with Pediatrician physically for further evaluation and treatment
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Dr. Shebin C E
Pediatrician
10 yrs exp
Kanyakumari
Greetings
For a healthy, term infant born at or after 38 weeks of gestation, a total serum bilirubin level of 16.3 mg/dL at approximately 11 days of life is typically below the standard clinical threshold required for phototherapy, provided the infant is well-appearing, feeding adequately, gaining weight, and presents with no additional neurotoxicity risk factors. When neonatal jaundice is prolonged past the first week of life, the differential diagnosis generally includes benign breastmilk jaundice, suboptimal intake jaundice, congenital hypothyroidism, or neonatal infection. While current management for a thriving, asymptomatic infant involves standard outpatient monitoring with a potential repeat bilirubin check in two weeks, caregivers must seek immediate medical assessment if clinical red flags develop. These urgent warning signs include lethargy, difficulty waking to feed, a high-pitched or abnormal cry, altered muscle tone such as hypotonia or hypertonia, fever, visibly worsening skin discoloration, reduced urinary output, deeply colored urine, or pale, clay-colored stools.
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