Which sign indicates that a newborn may require further assessment during phototherapy?

In the context of phototherapy for newborns, increased bilirubin levels can indicate that the treatment is not effectively reducing the bilirubin concentration in the baby's system. Under normal circumstances, the purpose of phototherapy is to convert bilirubin into a form that can be more easily excreted by the body. If bilirubin levels rise despite ongoing treatment, it suggests that the underlying issue may need further evaluation. This can indicate that the newborn is not responding adequately to the therapy or may have a more serious condition affecting bilirubin metabolism.

The other signs may not suggest a need for further assessment during phototherapy. For example, decreased body temperature can occur for various reasons, including environmental factors, and might not directly relate to the effectiveness of phototherapy. An improved skin tone typically indicates that bilirubin levels are decreasing, which is a positive response to treatment, and maintenance of feeding patterns suggests stability in the newborn's overall health and hydration status. Thus, increased bilirubin levels is the primary indicator that warrants further assessment.