History of Present Illness

Onset and progression of jaundiced skin

Feeding: breast milk or formula?
Current weight compared to birth weight. Gaining weight appropriately?
Number of wet diapers per day? (Indicator of hydration status)
Consistency and colour of stool?(pale stool implies poor bili excretion)
Infections or fever?
Medications? (newborn or mother)
General activity: irritable? lethargic?
Gender & ethnicity? (Males, Asians, and Blacks have some increased risk

Perinatal History

Maternal blood group

Maternal illnesses or infections
Results of antenatal screening tests
Maternal medicine or drug intake
Delayed cord clamping (could indicate polycythemia)
Birth trauma with bruising
Results of newborn screening tests

Family History:

Previous siblings with neonatal jaundice

Other family members with jaundice
Anemia or blood disorders
Splenectomy
Bile stones or gallbladder removal

Merck Manual
History of present illness should note age of onset and duration of jaundice.
Important associated symptoms include lethargy and poor feeding (suggesting possible
kernicterus), which may progress to stupor, hypotonia, or seizures and eventually to
hypertonia. Patterns of feeding can be suggestive of possible breastfeeding failure or
underfeeding. Therefore, history should include what the infant is being fed, how much
and how frequently, urine and stool production (possible breastfeeding failure or
underfeeding), how well the infant is latching on to the breast or taking the nipple of the
bottle, whether the mother feels that her milk has come in, and whether the infant is
swallowing during feedings and seems satiated after feedings.
Review of systems should seek symptoms of causes, including respiratory distress,
fever, and irritability or lethargy (sepsis); hypotonia and poor feeding (hypothyroidism,
metabolic disorder); and repeated episodes of vomiting (intestinal obstruction).
Past medical history should focus on maternal infections (toxoplasmosis, other
pathogens, rubella, cytomegalovirus, and herpes simplex [TORCH] infections), disorders
that can cause early hyperbilirubinemia (maternal diabetes), maternal Rh factor and
blood group (maternofetal blood group incompatibility), and a history of a prolonged or
difficult birth (hematoma or forceps trauma).

Family history should note known inherited disorders that can cause jaundice, including
G6PD deficiency, thalassemias, and spherocytosis, and also any history of siblings who
have had jaundice.
Drug history should specifically note drugs that may promote jaundice (eg, ceftriaxone,
sulfonamides, antimalarials).
Medscape
Presentation and duration of neonatal jaundice

Typically, presentation is on the second or third day of life.

Jaundice that is visible during the first 24 hours of life is likely to be nonphysiologic;
further evaluation is suggested.
Infants who present with jaundice after 3-4 days of life may also require closer
scrutiny and monitoring.
In infants with severe jaundice or jaundice that continues beyond the first 1-2
weeks of life, the results of the newborn metabolic screen should be checked for
galactosemia and congenital hypothyroidism, further family history should be
explored (see below), the infant's weight curve should be evaluated, the mother's
impressions as far as adequacy of breastfeeding should be elicited, and the stool
color should be assessed.

Family history

Previous sibling with jaundice in the neonatal period, particularly if the jaundice
required treatment
Other family members with jaundice or known family history of Gilbert syndrome
Anemia, splenectomy, or bile stones in family members or known heredity for
hemolytic disorders
Liver disease in family members

History of pregnancy and delivery

Maternal illness suggestive of viral or other infection

Maternal drug intake
Delayed cord clamping
Birth trauma with bruising and/or fractures.

Postnatal history

Loss of stool color

Breastfeeding
Greater than average weight loss
Symptoms or signs of hypothyroidism
Symptoms or signs of metabolic disease (eg, galactosemia)
Exposure to total parental nutrition