A 5-day-old female infant presented to a children’s hospital emergency department (ED) with jaundice. She was born at 38 weeks’, 4 days’ gestation with a weight of 3400 g after an unremarkable pregnancy and perinatal course. By parental report, a 36-hour bilirubin level was 9 mg/dL, and she did not receive phototherapy. Her mother’s blood type was B, Rh positive. The baby was exclusively breastfed, nursing every 2 to 4 hours for 20 minutes per breast. Voiding and stooling patterns were appropriate. In the ED, she was afebrile and well appearing with a weight of 3380 g. At 130 hours after birth, her total serum bilirubin (TSB) was 19.4 mg/dL. The ED provider decided to admit the patient for intensive phototherapy. During her observation in the ED, the infant had acute decreases in oxyhemoglobin saturation by pulse oximetry (SpO2) to 90% while asleep, self-resolving within seconds. Therefore, the...

You do not currently have access to this content.