Sorry to be getting in on this so late, it is about the baby with a
bilirubin level of 13 at about 10 days (if I remember correctly).
According to the protocols we use, this baby would not even be checked
anymore as long as the bilirubin was unconjugated and the level was known to
be falling.
If there was pathology present, i.e. blood group incompatibility, we would
check hemoglobin levels after a month or so, and consider iron
supplementation if needed.

If the level seemed not to have peaked yet, the baby would be checked until
it could be determined that the bilirubin was declining.  Intervals between
blood tests would depend on whether baby is feeding well, gaining normally,
and alert when awake, and might be as great as one week or as short as a day
or two.

We follow babies with pronounced non-pathologic jaundice until levels peak.
Our threshold for phototherapy in term babies (over 37 completed gestational
weeks at birth) is just over 20 by day 5, and our threshold for stopping
follow-up blood tests is about 15.  That means that once the baby's
bilirubin has dropped to 15 or below, we don't worry about it any more.  Any
concurrent feeding problems or growth problems are seen out of the context
of the bili levels after that point.

For moderately premature babies, the ones not needing special nursery care
but who are less than 37 weeks at birth, the treatment threshold at 5 days
is 15, and for stopping follow-up blood tests it is about 12.

Numbers are approximate because we use different units.  The conversion
factor between them is 17, so our nice round numbers turn into raggedy
things with two decimal places in your units.

Rachel Myr
Kristiansand, Norway

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