Re jaundiced baby:

I will freely admit that,while not totally arbitrary in my evaluation of
jaundice, I go largely by a bunch of intangibles (well, semi-tangibles!). So
far, my instincts have been pretty good - only 1 or 2 that I've sent to dr.
for bloodwk that got pooh-poohed, and a few really spectacular saves. I've
never found those charts for estimating to be as useful as I'd like. I guess
I mostly go by how the kid is acting - some are regular pumpkins, but if
they're nsg. well, voiding & stooling well, and alert & vigorous, I tend to
not get alarmed. But there are others, not nearly as jaundiced to look at,
that smell a little off and have that dozey, lethargic look, or maybe
stools/voids aren't "right", and my warning buzzer goes off.

I have found, though, that giving visual guidelines to parents is almost
useless; they either can't see it when to me it's glaring, or they are
positive that the child is turning orange, or the racially-related skin
tones are a factor. I think it's one of those things that comes with lots of
experience. But it's not just the color, or over what parts of the body,
it's the whole "set-up" - ABO, gestational age, ruddiness or bruising @
birth, other factors.

Cathy Bargar RN, IBCLC Ithaca NY