Neonatal Jaundice Risk Assessment (Bhutani Nomogram)
Assesses risk of significant hyperbilirubinaemia in newborns using hour-specific total serum bilirubin (TSB) plotted on the Bhutani nomogram. Guides phototherapy and exchange transfusion decisions.
Score interpretation
→ Low zone (TSB in low-risk range for age): Low risk of significant hyperbilirubinaemia. Routine monitoring; ensure adequate feeding (8–12 feeds/day); reassess bilirubin in 24–48 hours if discharged.
→ Low-intermediate zone: Low-intermediate risk. Plot on Bhutani nomogram with hour-specific value. Reassess before discharge; outpatient TSB check at 24–48 hours. Promote breastfeeding support.
→ High-intermediate zone: Elevated risk. Initiate phototherapy if TSB above NICE threshold for gestational age at this hour. Check: blood group, DAT (Coombs), G6PD in at-risk populations; FBC. Review risk factors.
→ High zone (TSB ≥256 μmol/L or term neonate): High risk. Intensive phototherapy immediately. If TSB at exchange threshold (typically >450 μmol/L in term, lower in preterm): emergency exchange transfusion. NICU admission. Urgent haematology. Check G6PD deficiency.
Interpretation bands for the Neonatal Jaundice. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Colestyramine (Cholestyramine) · Bile Acid Sequestrant / Ion Exchange Resin
- Rozanolixizumab · Neonatal Fc receptor (FcRn) antagonist
- Efgartigimod alfa · Neonatal Fc receptor (FcRn) blocker
- Phenobarbital (Paediatric Epilepsy — Beyond Neonatal) · Barbiturate Anticonvulsant
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Aciclovir (Paediatric) · Antiviral — HSV Encephalitis / Neonatal Herpes / VZV in Immunocompromised
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.