But generally what you see is these babies present more at 3-6 weeks of age and sometimes the diagnosis can be delayed after that. Medications, drugs that Risk factors for sepsis though, again, septic babies, jaundice is not going to be a presenting sign of sepsis. Family history is very important in jaundice. Any of the inherited causes, so things like spherocytosis or elliptocytosis, some of the conjugating or enzyme deficiencies, Gilbert s, Crigler-Najjar, family history may be important. History of anemias, some of the hemoglobinopathies, and again, structural problems such as elliptocytosis and spherocytosis may see a positive family history.
Splenectomy can be suggestive of spherocytosis.
Well talk about management of indirect hyperbilirubinemia next. You don t want to give these kids IV fluids. Again, the reason you want to do that is you want to use the benefit of the enterohepatic circulation and get that stool and that bilirubin out of the gut as quickly as possible. The second is phototherapy. You aren t probably going to get asked this on the Boards because it s fairly controversial, not a lot of great studies recently.