BENIGN TRANSIENT HYPERBILIRUBINEMIA OF THE NEWBORN:

Currently we placed all healthy term infants under phototherapy when their serum bilirubin 15 mg/dl. In an effort to reevaluate our management of jaundice in our normal nursery population we screened 6,500 infants. Eight percent of these infants had peak bilirubin levels > 12 mg/dl and were held in the hospital after maternal discharge for further evaluation. Two-thirds of this group had clinical and laboratory evidence of hemolytic disease. One-third of the held infants (n=100) had no clinical, historical, or laboratory explanation for their hyperbilirubinemia. We are calling this condition benign transient hyperbilirubinemia of the newborn. The majority of these infants peaked at 14 mg/dl and required no treatment. Only three of the 100 infants had bilirubins > 18 mg/dl and were treated with phototherapy. In conclusion we believe that we have identified a benign process in our infants for which treatment has been very arbitrary. All standard laboratory tests to evaluate jaundice except the Coombs test were not helpful in identifying this group of infants. Finally, the arbitrary treatment of healthy, term infants with benign transient hyperbilirubinemia needs to be re-evaluated.