Patricia Blomme and lactnuts all--
It sounds like Canada uses the same units as we do here, which are
millimoles per liter.  I don't know what quaint archaic units the US goes by
(cubits per bushel or drams per acre or some other incomprehensibly
non-metric but very poetical terms) but I DO know that if you divide your
numbers by the magic number 17, you will end up with numbers like in the
Peds text you have.
20 corresponds to 340, 10 to 170, etc.
In most hospitals here, we use lights if a term baby is over 350
millimoles/liter on or after the 3rd day of life, and at lower levels in the
first three days, the earlier, the lower the threshold for treatment.
Babies born at less than 37 weeks are also treated at lower levels.  I
believe there are some hospitals who use older treatment threshholds and who
treat even more babies with lights than we do.
You don't mention anything in your post which offers any cause other than
physiologic ones for this baby's symptoms.  I am wondering whether there was
more here to support the designation pathology.  Since we probably
over-treat this problem, I try to reserve the term 'pathological' for cases
in which the jaundice is due to blood group incompatibility, infection,
liver disease, biliary tract anomalies or other unusual causes.  Babies who
have very pronounced physiologic jaundice do 'need' treatment according to
the guidelines and limits of normal we have arbitrarily set, but I am
reluctant to call it pathological.
Sounds like you made a positive difference in the life of this family.  Good
job.
Rachel Myr
Kristiansand, Norway

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