Neonatal jaundice: breast milk jaundice: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatal jaundice: breast milk jaundice

Sample item

A thriving, exclusively breastfed 10-day-old term infant has a bilirubin of 12 mg/dl, normal stools and no haemolysis. What is the most likely diagnosis and best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Breast milk jaundice; continue breastfeeding and observe

Breast milk jaundice starts after the first week, peaks at about 2 weeks and can last up to 12 weeks in a thriving baby. Feeding should continue because bilirubin is indirect and the baby is otherwise well. Biliary atresia is excluded by normal coloured stools and conjugated bilirubin.

Option by option

  • A. Crigler-Najjar syndrome; liver transplant

    Crigler-Najjar presents with severe unconjugated jaundice in the first days.

  • B. Breast milk jaundice; continue breastfeeding and observe (correct)

    Correct. A well baby with indirect bilirubin late in week 1 has breast milk jaundice.

  • C. Biliary atresia; urgent Kasai

    Biliary atresia causes conjugated hyperbilirubinaemia and pale stools.

  • D. Haemolytic disease; exchange transfusion

    Haemolytic disease presents within 24 to 48 hours.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Breast milk jaundice; continue breastfeeding and observe. Breast milk jaundice starts after the first week, peaks at about 2 weeks and can last up to 12 weeks in a thriving baby.

Why is "Crigler-Najjar syndrome; liver transplant" not the answer?

Crigler-Najjar presents with severe unconjugated jaundice in the first days.

Why is "Biliary atresia; urgent Kasai" not the answer?

Biliary atresia causes conjugated hyperbilirubinaemia and pale stools.

Why is "Haemolytic disease; exchange transfusion" not the answer?

Haemolytic disease presents within 24 to 48 hours.

What concept does this question test?

It tests Neonatal jaundice: breast milk jaundice in Pediatrics. Feeding should continue because bilirubin is indirect and the baby is otherwise well. Biliary atresia is excluded by normal coloured stools and conjugated bilirubin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatal jaundice: breast milk jaundice?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.