Neonatal jaundice, but can you figure out why?
A 3-day old boy presents with jaundice from the 2nd day of life. He was born via caesarean section at 38 weeks of gestation, following an uncomplicated pregnancy. His mother is 26 years old and in good health.
On examination, anterior fontanelle: 4X5 cm; posterior fontanelle: 1X1 cm (both larger than expected for age)
Vital signs: Stable
Skin and sclera: icteric
Weight: 3.1 kg (50th centile)
Length: 49 cm (50th centile)
Head circumference: 34 cm (90th centile)
Abdomen: distended with liver palpable 1cm below the costal margin.
A FBC and blood film reveal Hb= 14.2 g/dl, PCV= 41.4%, Reticulocyte count: 3%
Blood film: Appears normal with no evidence of hemolysis
Serum bilirubin; 19.2 mg/dl with direct (conjugated) bil.=1.9 mg/dl
Liver transaminases are within normal ranges.
What do you suspect is the reason for this infant's jaundice?