Guidelines for Phototherapy

  • Use total bilirubin.  Do not subtract direct (conjugated) bilirubin.
  • Risk factors = isoimmune hemolytic disease, G6PD deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis, or albumin <3g/dL
  • For well infants 35 - 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line.  It is an option to intervene at lower TSB levels for infants closer to 35 wks and at higher TSB levels for those closer to 37 6/7 wks.
  • It is an option to provide conventional phototherapy in hospital or at home at TSB levels 2 - 3 mg/dL below those shown, but home phototherapy should not be used in any infant with risk factors.

Jaundice, Coombs, and Phototherapy