In his review of four large published studies of children presenting to emergency departments with a petechial rash, two studies totaling 408 patients concluded that no one with petechiae located only above the nipple line
had invasive bacterial disease.
However, maternal use of the Ingram icterometer and determination of jaundice in relation to the infant's nipple line are both potentially useful methods of assessing jaundice after hospital discharge.
The mothers' icterometer readings and determinations of jaundice to the nipple line or below it are compared with bilirubin levels in Table 1.
The mothers of the 3 infants with bilirubin levels [greater than or equal to] 17 mg/dL recognized that their infants were jaundiced and determined that the jaundice extended below the nipple line.
15) The authors did conclude, however, that finding no jaundice below the nipple line reliably predicted that an infant would have a bilirubin concentration of less than 12.