A 5-day-old exclusively breastfed term neonate presents with jaundice. Total serum bilirubin is 16 mg/dL (unconjugated). The baby is feeding well, stooling normally, and gaining weight. Coombs test is negative, and there is no evidence of hemolysis. What is the MOST likely diagnosis?
- A ABO incompatibility
- B Glucose-6-phosphate dehydrogenase deficiency
- C Breast milk jaundice ✓
- D Biliary atresia
Correct answer: C. Breast milk jaundice
Explanation
Breast milk jaundice presents after the first week of life in an otherwise well, thriving neonate with unconjugated hyperbilirubinemia and no evidence of hemolysis. ABO incompatibility typically presents earlier with a positive Coombs test. G6PD deficiency causes hemolysis with Heinz bodies on smear. Biliary atresia presents with conjugated hyperbilirubinemia and pale stools.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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