A female infant weighing 2,730 g is born at 37+4 weeks of gestation by elective cesarean delivery to a multigravida mother. This is the mother's fifth pregnancy. She has had 3 abortions and an undiagnosed neonatal death at 30 days. The infant who died suffered unexplained neonatal jaundice and received an exchange transfusion at 10 days of age.

Because of poor obstetric history and death of the last infant, the parents were very apprehensive. This infant developed jaundice on day 1 of age. Because of her total serum bilirubin (SBR) of 5.4 mg/dL (92.3 μmol/L) at 15 hours and 9.6 mg/dL (164.1 μmol/L) at 24 hours of age, she was referred to the authors’ practice.

On arrival, at 2 days of age, she had jaundice, with a heart rate of 120 beats per minute, respiratory rate of 65 breaths per minute, oxygen saturation of 95% in room air, and a...

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