Question

A father brings his two-week-old baby daughter to see you for review following a recent hospital admission with jaundice. The diagnosis on the discharge summary is 'Physiological Jaundice'.

Which ONE of the following is LEAST likely to be associated with this patient’s presentation? 

1. Low birth weight

2. Prematurity

3. Cephalhaematoma

4. Breast-feeding

5. Hypothyroidism

Physiological jaundice results from increased erythrocyte breakdown and immature liver function. It typically presents at two or three days old, begins to disappear towards the end of the first week and has resolved by day 10. The bilirubin level does not usually rise above 200 μmol/l and the baby remains well. 

Breast-feeding, cephalhaematoma, prematurity and low birth weight are all causes of physiological jaundice in the newborn. It does not usually require any specific treatment. 

Hypothyroidism is a metabolic cause of neonatal jaundice, and this requires further investigation and treatment.

References

•  Jaundice in the newborn (CKS)