A 4 week old female was presented to the office with parental reports of increasing jaundice over the last week. Her parents reported that 2 weeks ago, she began to have yellowing of her eyes with subsequent yellowing of her skin when she was diagnosed with physiologic jaundice. After persistent jaundice for 5 days, her parents changed her from breast-feeding to a commercial formula. Since the jaundice appeared to be worsening, her parents decided to bring her in for re-evaluation. Her stools have been pale in color for the past 10 days along with darker urine.
She was born by spontaneous vaginal delivery to a G2P1 A+ mother at 39 weeks with Apgar scores of 9 and 9 and 1 and 5 minutes. There were no complications noted at birth, the nursery, or at discharge home. The patient was not jaundiced at discharge or when seen at initial office visits. Her highest bilirubin previously was…
