Jaundice in the first 24 hours

Jaundice in the first 24 hours is always pathological.

Causes of jaundice in the first 24 hrs

• rhesus haemolytic disease
• ABO haemolytic disease
• hereditary spherocytosis
• glucose-6-phosphodehydrogenase

Jaundice in the neonate from 2-14 days

Jaundice in the neonate from 2-14 days is common (up to 40%) and usually physiological. It is due to a combination of factors, including more red blood cells, more fragile red blood cells and less developed liver function.

It is more commonly seen in breastfed babies

Jaundice after 14 days (prolonged)

If there are still signs of jaundice after 14 days (21 days if premature) a prolonged jaundice screen is performed, including:

• conjugated and unconjugated bilirubin: the most important test as a raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention
• direct antiglobulin test (Coombs' test)
• TFTs
• FBC and blood film
• urine for MC&S and reducing sugars
• U&Es and LFTs

Causes of prolonged jaundice

• biliary atresia