A nurse is teaching a parent about how to prevent physiologic jaundice in a breastfed newborn.

Which of the following instructions should the nurse include?

This is because breastfeeding frequently can help the newborn pass more stools, which contain bilirubin, and reduce the risk of jaundice.

Choice A is wrong because supplementing breastfeeding with glucose water can reduce the amount of breast milk intake and increase the risk of jaundice.

Choice B is wrong because exposing the newborn to natural sunlight for short periods has not been proven to be effective in preventing or treating jaundice.

Moreover, sunlight can cause sunburn and dehydration in newborns.

Choice D is wrong because it includes choices A and B, which are incorrect.

Physiologic jaundice is a common and harmless condition that occurs in newborns due to the immature liver function and increased breakdown of red blood cells.It causes yellow discoloration of the skin and eyes due to the accumulation of bilirubin, a yellow pigment of red blood cells.Physiologic jaundice usually appears between the second and fourth day after birth and resolves within one to two weeks.Normal ranges of bilirubin levels vary depending on the age, gestational age, and health status of the newborn, but generally they are below 5 mg/dL (86 micromol/L) at term.

This method allows the nurse to detect jaundice by observing the color of the skin after applying and releasing pressure.

This is a simple and noninvasive way to check for jaundice in a newborn.

Choice A is wrong because palpating the newborn’s abdomen for hepatomegaly is not a reliable way to detect jaundice.Hepatomegaly is an enlargement of the liver that may indicate liver disease, but it is not specific to jaundice.

Choice B is wrong because measuring the newborn’s serum bilirubin level is not a method to detect jaundice, but rather to confirm and quantify it.

Serum bilirubin level is the amount of bilirubin in the blood, which is responsible for the yellow color of jaundice.A blood test is required to measure this level.

Choice D is wrong because observing the newborn’s urine and stool color is not a reliable way to detect jaundice.

The color of urine and stool may vary depending on the hydration status, feeding type and other factors of the newborn.Moreover, urine and stool color may not change until the bilirubin level is very high.