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Pediatrics
Neonatal Jaundice (Bhutani Nomogram)
Pediatrics

Neonatal Jaundice — Phototherapy Thresholds

AAP 2022 bilirubin management guidelines for newborns

0 – 168 hours (0 – 7 days)
Risk Factors (lower threshold by 2 mg/dL if any present)
Neonatal Jaundice Results
Gestational age <35 weeks: Refer to neonatology — individualized management required. Phototherapy thresholds are not calculated here for preterm infants.
Patient TSB—
Phototherapy Threshold—
Exchange Transfusion Threshold—
Risk Zone—

Risk Zone Classification

Low Risk
Low-Intermediate
High-Intermediate
High Risk
Age (hrs)Phototherapy (term, no RF)Exchange Transfusion
24h8.0 mg/dL13.0 mg/dL
36h10.5 mg/dL15.5 mg/dL
48h12.5 mg/dL17.5 mg/dL
60h14.0 mg/dL19.0 mg/dL
72h15.0 mg/dL20.0 mg/dL
96h17.0 mg/dL22.0 mg/dL
120h+18.0 mg/dL23.0 mg/dL

Thresholds & Adjustments

Base thresholds: AAP 2022 hour-specific Bhutani nomogram for term infants
Late preterm (35–37+6 wk): Subtract 2 mg/dL from term thresholds
Risk factors present: Subtract additional 2 mg/dL
Exchange transfusion: Approximately phototherapy threshold + 5 mg/dL

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