Neonatal hyperbilirubinemia--an update for South Dakota physicians.

Most newborn infants develop hyperbilirubinemia in the neonatal period. Excessive levels of hyperbilirubinemia places the infant at risk for bilirubin encephalopathy. We discuss the metabolism of bilirubin and the most likely etiologies for elevated bilirubin levels in the newborn. We describe methods to evaluate bilirubin levels and the formal hyperbilirubinemia risk assessment each infant deserves prior to discharge from the nursery. In addition, we review management of infants with hyperbilirubinemia, including phototherapy, intravenous immunoglobulin and exchange transfusion.