In neonates, what is a sign of severe hyperbilirubinemia?

In neonates, the presence of jaundice is a key sign of hyperbilirubinemia, particularly when it is severe. Jaundice, characterized by a yellowing of the skin and sclera, occurs when there is an accumulation of bilirubin in the bloodstream. In neonates, this condition can arise due to various factors such as physiological newborn jaundice, hemolytic diseases (like Rh or ABO incompatibility), or liver dysfunction.

When bilirubin levels exceed the normal thresholds, the risk of kernicterus, a form of bilirubin encephalopathy, increases, making the identification of jaundice crucial for timely management. While other signs such as pallor, cyanosis, and cachexia can indicate various medical conditions in neonates, they are not specific indicators of hyperbilirubinemia. Therefore, the presence of jaundice serves as a direct marker for the severity of hyperbilirubinemia in this population.