Physiologic jaundice in the newborn is typically managed how, including onset and when phototherapy is considered?

• A. Onset around day 2-3, peaks day 5-7; managed with adequate feeding and phototherapy if bilirubin reaches treatment thresholds.
• B. Onset at birth; always requires phototherapy.
• C. Onset day 14; managed with avoidance of feeding.
• D. Onset day 1-2; managed with formula supplementation only.

Answer: (A)

Physiologic jaundice happens because a newborn’s liver is still maturing its ability to conjugate and excrete bilirubin, while there’s also higher bilirubin production after birth. It typically becomes evident after the first day, usually around day 2–3, peaks around day 5–7, and then declines as liver conjugation improves. The plan emphasizes keeping the baby well hydrated and fed—adequate feeding promotes frequent stooling, which helps eliminate bilirubin and reduces enterohepatic circulation. Phototherapy is used only when bilirubin levels reach treatment thresholds defined by the infant’s age in hours and risk factors; it speeds up bilirubin breakdown into water-soluble forms that can be excreted. So the described onset and the conditional use of phototherapy align with the standard management of physiologic jaundice.