Hemolytic disease of the fetus and newborn (HDFN), which includes ABO/Rh incompatibility.Typically occurs in the second week of life, but may last 3 months.Occurs because breastmilk contains β-glucuronidase and fatty acids that inhibit conjugating enzymes.Typically occurs in the first week of life.
Results from caloric deprivation, leading to increased enterohepatic circulation. Lactation/breastfeeding failure jaundice (previously known as breastfeeding jaundice). Results from increased bilirubin production (more RBCs with shorter lifespan), increased hematocrit relative to body weight, and immature conjugation enzymes. Non-pathologic forms are always indirect pathologic forms are either indirect or direct. The DDx for hyperbilirubinemia is broad, but generally divided into indirect and direct forms. The conjunctiva is an amazing number of functions-much more than meets the eye!. Thus, when we see yellowing of the eyes in patients with jaundice, we should use the term “conjunctival icterus”-”scleral icterus” is a misnomer! In the eye, elastin is predominantly found in the innermost layer of the conjunctiva (the subepithelial lamina propria) and the contiguous episclera. Jaundice occurs because bilirubin binds elastin, which is found predominantly in the skin (including the lingual frenulum). UCB can become unbound if albumin is saturated or if it’s displaced by certain drugs (e.g., sulfa, streptomycin, CTX, ibuprofen, chloramphenicol) free bilirubin can cross the blood-brain barrier and cause CNS toxicity. Unconjugated bilirubin (UCB) binds albumin in the bloodstream on its way to the liver. What is the most likely cause of this patient’s presentation? 
He has jaundice, a high-pitched cry, weak suck, and mild generalized hypotonia. On physical examination, his weight is 3.1 kg. He has been breastfeeding every 2 to 3 hours since discharge from the hospital 24 hours after birth. He was born vaginally, with a birthweight of 3.5 kg.
His mother had a history of gestational diabetes. A 3-day-old neonate born at 36 weeks’ gestation is being evaluated.
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