Neonatal Bilirubin — AAP 2022

Phototherapy & exchange-transfusion thresholds for infants ≥35 weeks, by gestational age, hours of age and neurotoxicity risk.

Gestational age at birth

Age at measurement (hours) 0–336 h (to 14 days)

Total serum bilirubin (TSB)

Albumin (optional, for B/A ratio)

Neurotoxicity risk factors (other than gestational age)

Isoimmune hemolytic disease (positive DAT) G6PD deficiency or other hemolytic condition Sepsis Significant clinical instability in the previous 24 h Albumin < 3.0 g/dL

Infant is currently receiving phototherapy

Not a risk factor — tick this to calculate the stop threshold.

Age when phototherapy was started (hours) The stop threshold is anchored to this hour, not the current hour.

Optional — date/time helper & rate of rise

Date & time of birth

Date & time of measurement

Previous TSB (mg/dL)same unit as the TSB field above

…at age (hours)

Phototherapy at

–

mg/dL

Exchange at

–

mg/dL

Patient TSB

–

mg/dL

Thresholds per the 2022 AAP clinical practice guideline (Kemper et al., Pediatrics 2022). Conversion: µmol/L = mg/dL × 17.1.
Enter the total serum bilirubin — do not subtract direct-reacting or conjugated bilirubin from the total. In rare cases of severe hyperbilirubinemia in which the direct-reacting or conjugated bilirubin exceeds 50% of the TSB, consult an expert.

Decision support only — confirm against the official AAP 2022 nomograms and your institution’s protocol, and interpret with the full clinical picture (trend, exam, feeding). Not a substitute for clinical judgment.