<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An otherwise healthy, exclusively breastfed 4-day-old neonate is brought to the physician because of yellowing of his skin and eyes. His urine has been clear and stools have been normal. He was born at term by vacuum-assisted delivery and weighed 4000 g 8 lb 8 oz. Pregnancy was complicated by gestational diabetes mellitus. His older sibling had jaundice in the neonatal period. Vital signs are within normal limits. He appears alert and comfortable. Physical examination shows jaundice of the skin and sclerae. The liver is palpated 1 cm below the right costal margin. Laboratory studies show:Hemoglobin 17 gdlReticulocyte count 0.5 Total bilirubin 21.2 mgdlDirect bilirubin 2 mgdlIndirect bilirubin 19.1 mgdlCoombs test NegativeWhich of the following is the most appropriate next step in management?? A: Intravenous immunoglobulin, B: Increase frequency of breast feeds, C: Replace breast feeding with formula feeds, D: MRI of the brain, E: Phototherapy,  <response>: This is a question about neonatal jaundice in an otherwise healthy newborn. The key findings are jaundice in a 4-day-old breastfed infant with no evidence of hemolysis based on normal hemoglobin, negative Coombs test, and normal stool color. The total bilirubin is elevated at 21.2 mgdL, with a predominance of indirect bilirubin. This clinical picture is most consistent with physiologic jaundice of the newborn, likely exacerbated by breastfeeding and the history of gestational diabetes. The answer choices include various management options. Choice A IVIG would be indicated for isoimmune hemolytic disease, which is ruled out here. Choice B increasing breastfeeding frequency can help by increasing bilirubin elimination in stool. Choice C formula feeding also increases elimination but is not necessary as first-line therapy. Choice D MRI brain is not indicated in simple jaundice. Choice E phototherapy is the most appropriate next step to treat the hyperbilirubinemia.E: Phototherapy 