pathways.html ) (Copyright © 2014 by The Children’s Hospital of Philadelphia All rights reserved.) Beyond the Neonatal Period For patients beyond the neonatal period, the approach is primarily directed at identification and treatment of the underlying cause In some cases of severe hyperbilirubinemia, such as those caused by Crigler–Najjar syndrome type II and Lucey–Driscoll syndrome, phototherapy or phenobarbital may be indicated If a patient appears acutely ill, the physician should proceed with the appropriate evaluation and treatment for sepsis Among well-appearing patients, the presence or absence of anemia determines the likely diagnostic possibilities and appropriate studies When unconjugated hyperbilirubinemia occurs without anemia, abnormal liver function tests will differentiate hepatic disease from inherited disorders of bilirubin metabolism Anemic children should be evaluated for an underlying hemolytic process Suggested Readings and Key References American Academy of Pediatrics Subcommittee on Hyperbilirubinemia Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation Pediatrics 2004;114(1):297–316 Johnson L, Bhutani VK The clinical syndrome of bilirubin-induced neurologic dysfunction Semin Perinatol 2011;35:101–113 Lai NM, Ahmad Kamar A, Choo YM, et al Fluid supplementation for neonatal unconjugated hyperbilirubinaemia Cochrane Database Syst Rev 2017;8:CD011891 Maisels MJ, McDonagh AF Phototherapy for neonatal jaundice N Engl J Med 2008;358(9):920–928 Wolff M, Schinasi DA, Lavelle J, et al Management of neonates with hyperbilirubinemia: improving timeliness of care using a clinical pathway Pediatrics 2012;130(6):e1688–e1694