Neonatal jaundice — likely cause
For each clinical scenario below, select the SINGLE most likely cause of the infant's jaundice from the option list above. Each option may be used once, more than once, or not at all.
- A. Physiological jaundice
- B. Breast milk jaundice
- C. ABO incompatibility
- D. Rhesus haemolytic disease
- E. Biliary atresia
- F. Congenital hypothyroidism
- G. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- H. Sepsis
- I. Cephalhaematoma resorption
- J. Crigler-Najjar syndrome
1. A term baby becomes visibly jaundiced on day 2 of life. Mother is blood group O, baby is group A. Direct antiglobulin test is positive. Bilirubin is rising rapidly and phototherapy is started.
2. A 3-week-old, otherwise thriving, exclusively breastfed baby has persistent mild jaundice. Conjugated bilirubin is normal, unconjugated bilirubin is mildly elevated, and the baby is feeding and growing well.
3. A 2-week-old baby has persistent jaundice with pale stools and dark urine. Conjugated bilirubin is significantly elevated. Urgent referral is required.
4. A baby born by ventouse delivery develops a firm, non-fluctuant swelling confined to one parietal bone that does not cross suture lines, and mild jaundice appears towards the end of the first week as the swelling resolves.
5. A term baby of Mediterranean descent becomes acutely jaundiced and unwell with dark urine 48 hours after the mother, who is breastfeeding, ate fava beans.