Because the prevention of Rh antibody formation has been available for almost 50 years, the disorder is now most often caused by an ABO incompatibility. In the past, hemolytic disease of the newborn was most often caused by an Rh blood type incompatibility. Breast milk jaundice occurs in breastfed newborns between the first and third day of life but peaks by day 5 to 15, with a decline occurring by the third week of life (Morrison, 2021). Pathological jaundice is defined as the appearance of jaundice in the first 24 hours of life due to an increase in serum bilirubin levels greater than 5 mg/dl/day, conjugated bilirubin levels ≥ 20% of total serum bilirubin, peak levels higher than the normal range, and the presence of clinical jaundice greater than two weeks. This unconjugated hyperbilirubinemia presents in newborns after 24 hours of life and can last up to the first week. Physiological jaundice is the most common type of newborn hyperbilirubinemia. It lasts longer, which predisposes the infant to hyperbilirubinemia or excessive bilirubin levels in the blood. The normal rise in bilirubin levels in preterm infants is slower than in full-term infants. Physiological jaundice is normal, while pathological jaundice is more serious, which occurs within 24 hours of birth, and is secondary to an abnormal condition, such ABO- Rh incompatibility. The higher the blood bilirubin level is, the deeper jaundice and the greater risk for neurological damage. The liver cannot clear the blood of bile pigments that result from the normal postnatal destruction of red blood cells. The newborn‘s liver is immature, which contributes to icterus, or jaundice. The condition may be benign or place the neonate at risk for multiple complications/untoward effects. Hyperbilirubinemia is the elevation of serum bilirubin levels that is related to the hemolysis of RBCs and subsequent reabsorption of unconjugated bilirubin from the small intestines.
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