Materiały źródłowe

• #1 Newborn jaundice: Time for prevention?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2529433/

  Jaundice is still a major issue in term newborns. A CPSP study confirmed 258 cases of severe neonatal hyperbilirubinemia, with a mean peak total bilirubin level of 471 mol/L. The majority (70%) of these cases were readmitted to hospital after being discharged as normal newborns. […] Severe hyperbilirubinemia is the most common cause of infant readmission to hospital in Canada and the United States, and carries the possible risk of kernicterus and bilirubin-induced encephalopathy. […] Recommended preventive measures include: […] An assessment of all newborns for risk factors associated with potential hyperbilirubinemia, such as blood group incompatibility, a previously affected sibling, cephalhematoma, less than 38 weeks gestation at birth, risk of glucose-6-phosphate dehydrogenase deficiency and jaundice appearing in the first 24 h.

• #2 What are Jaundice and Kernicterus? | CDC

  https://archive.cdc.gov/www_cdc_gov/ncbddd/jaundice/facts.html

  Jaundice is the yellow color seen in the skin of many newborns. […] Early detection and management of jaundice can prevent kernicterus. […] No baby should develop brain damage from untreated jaundice. […] Jaundice is generally treated before brain damage is a concern. […] Early diagnosis and treatment of jaundice can prevent kernicterus. […] If you’re concerned that your baby might have jaundice visit your baby’s doctor right away. Ask for a jaundice bilirubin test. […] If your baby does have jaundice, it is important to take jaundice seriously and stick to the follow-up plan for appointments and recommended care. […] Make sure your baby is getting enough to eat. The process of removing waste also removes bilirubin in your baby’s blood. If you are breastfeeding, you should nurse the baby at least 8 to 12 times a day for the first few days. This will help you make enough milk for the baby and will help keep the baby’s bilirubin level down.

• #3 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  Kernicterus and neurologic sequelae caused by severe neonatal hyperbilirubinemia are preventable conditions. A structured and practical approach to the identification and care of infants with jaundice can facilitate prevention, thus decreasing rates of morbidity and mortality. Primary prevention includes ensuring adequate feeding, with breastfed infants having eight to 12 feedings per 24 hours. […] Secondary prevention is achieved by vigilant monitoring of neonatal jaundice, identifying infants at risk of severe hyperbilirubinemia, and ensuring timely outpatient follow-up within 24 to 72 hours of discharge. […] Physicians should encourage optimal breastfeeding (eight to 12 feedings per day) to decrease the incidence of hyperbilirubinemia. […] Physicians should promote and support breastfeeding, advising eight to 12 feedings per day for the first several days of life.

• #4 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html/1000

  Kernicterus and neurologic sequelae caused by severe neonatal hyperbilirubinemia are preventable conditions. A structured and practical approach to the identification and care of infants with jaundice can facilitate prevention, thus decreasing rates of morbidity and mortality. Primary prevention includes ensuring adequate feeding, with breastfed infants having eight to 12 feedings per 24 hours. Secondary prevention is achieved by vigilant monitoring of neonatal jaundice, identifying infants at risk of severe hyperbilirubinemia, and ensuring timely outpatient follow-up within 24 to 72 hours of discharge. Total serum bilirubin or transcutaneous bilirubin levels should be routinely monitored in all newborns, and these measurements must be plotted on a nomogram according to the infant’s age in hours. The resultant low-, intermediate-, or high-risk zones, in addition to the infant’s risk factors, can guide timing of postdischarge follow-up.

• #5 Jaundice in Newborns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns

  Jaundice in newborns is normal and usually can’t be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin. […] Breastfed babies: You should breastfeed your baby eight to 12 times a day during their first week of life. […] Formula-fed babies: You should give your baby one to two ounces (30 to 60 milliliters) of formula every two to three hours during their first week of life. Ensure at least eight feeds in a 24-hour period. […] Also, make sure your baby’s healthcare provider checks your baby’s bilirubin level before you leave the hospital. Schedule a follow-up visit during your baby’s first week of life to have the bilirubin level checked again.

• #6 Preventing Jaundice in Newborns: Tips for McKinney Parents

  https://www.kidsvillepeds.com/blog/1267962-how-to-prevent-jaundice-in-newborns/

  Newborn jaundice typically appears within the first few days after birth, manifesting as a yellowish tint to the skin and eyes. […] One of the simplest and most effective ways to prevent jaundice is to ensure your baby feeds frequently. Breastfeeding 8-12 times a day during the first week helps stimulate bowel movements, which assist in eliminating bilirubin from the body. […] Parents should stay vigilant for early signs of jaundice, such as yellowing of the skin and eyes, lethargy, or poor feeding. Identifying these symptoms early allows for timely consultation with a pediatrician, reducing the risk of severe jaundice. […] Light therapy (phototherapy) is a common treatment for jaundice, but you can take preventative measures by exposing your baby to indirect sunlight. […] A good latch ensures your baby gets enough milk, which is vital for regular bowel movements.

• #7 Jaundice in Newborns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns

  Jaundice in newborns is normal and usually can’t be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin. […] Breastfed babies: You should breastfeed your baby eight to 12 times a day during their first week of life. […] Formula-fed babies: You should give your baby one to two ounces (30 to 60 milliliters) of formula every two to three hours during their first week of life. Ensure at least eight feeds in a 24-hour period. […] Also, make sure your baby’s healthcare provider checks your baby’s bilirubin level before you leave the hospital. Schedule a follow-up visit during your baby’s first week of life to have the bilirubin level checked again.

• #8 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Mothers must be advised to breastfeed their newborns at least 8-12 times a day in the first days (grade I recommendation). […] A programme for breastfeeding support should be established in every health care institution that manages deliveries, with continuation in primary care (evidence level 5, grade I recommendation). […] Newborns that lose more than 10% of their birth weight should be assessed by a professional with specific training in breastfeeding (evidence level 5, grade I recommendation). […] The early identification of newborns at risk of developing significant hyperbilirubinaemia is key for its prevention. […] Every newborn should be assessed for the risk of developing hyperbilirubinaemia before discharge. This assessment is particularly important in infants who are discharged before the age of 72h (grade I recommendation).

• #9 Jaundice in Newborns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns

  Jaundice in newborns is normal and usually can’t be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin. […] Breastfed babies: You should breastfeed your baby eight to 12 times a day during their first week of life. […] Formula-fed babies: You should give your baby one to two ounces (30 to 60 milliliters) of formula every two to three hours during their first week of life. Ensure at least eight feeds in a 24-hour period. […] Also, make sure your baby’s healthcare provider checks your baby’s bilirubin level before you leave the hospital. Schedule a follow-up visit during your baby’s first week of life to have the bilirubin level checked again.

• #10 Infant jaundice: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/165358

  The best way of reduce chances of an infant developing jaundice is to make sure they are well fed. For the first week or so of life, breast-fed babies should be fed 8-12 times a day, while formula-fed babies should be fed 1-2 ounces of formula every 2-3 hours.

• #11 Preventing Jaundice in Newborns: Tips for McKinney Parents

  https://www.kidsvillepeds.com/blog/1267962-how-to-prevent-jaundice-in-newborns/

  Regular pediatric visits during the first week of life are vital for monitoring bilirubin levels. […] Colostrum, the nutrient-rich first milk produced after delivery, acts as a natural laxative, helping newborns pass their first stools (meconium). […] Dehydration can increase bilirubin levels, so it’s essential to ensure your baby stays hydrated. […] Understanding how to prevent jaundice in newborns can significantly reduce anxiety for new parents. […] Frequent feeding, monitoring for early signs, and maintaining regular pediatric check-ups are critical steps in keeping your baby healthy. By understanding how to prevent jaundice in newborns, parents can feel confident in providing the best care for their little ones, ensuring a bright and healthy start to life.

• #12 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. […] The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. […] An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology. […] Breastfed newborns are at greater risk of developing hyperbilirubinaemia than newborns fed artificial formula. However, the known risks of acute bilirubin encephalopathy are very small when weighed against the benefits of BF. The primary approach to mitigating the hyperbilirubinaemia associated to BF is to ensure that BF is successful.

• #13 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Mothers must be advised to breastfeed their newborns at least 8-12 times a day in the first days (grade I recommendation). […] A programme for breastfeeding support should be established in every health care institution that manages deliveries, with continuation in primary care (evidence level 5, grade I recommendation). […] Newborns that lose more than 10% of their birth weight should be assessed by a professional with specific training in breastfeeding (evidence level 5, grade I recommendation). […] The early identification of newborns at risk of developing significant hyperbilirubinaemia is key for its prevention. […] Every newborn should be assessed for the risk of developing hyperbilirubinaemia before discharge. This assessment is particularly important in infants who are discharged before the age of 72h (grade I recommendation).

• #14 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Mothers must be advised to breastfeed their newborns at least 8-12 times a day in the first days (grade I recommendation). […] A programme for breastfeeding support should be established in every health care institution that manages deliveries, with continuation in primary care (evidence level 5, grade I recommendation). […] Newborns that lose more than 10% of their birth weight should be assessed by a professional with specific training in breastfeeding (evidence level 5, grade I recommendation). […] The early identification of newborns at risk of developing significant hyperbilirubinaemia is key for its prevention. […] Every newborn should be assessed for the risk of developing hyperbilirubinaemia before discharge. This assessment is particularly important in infants who are discharged before the age of 72h (grade I recommendation).

• #15 Jaundice in Newborns: Signs, Treatment, and Prevention – Happiest Baby

  https://www.happiestbaby.com/blogs/baby/newborn-jaundice

  While theres no way to completely prevent newborn jaundice, there are things you can do to diminish the impact, such as […] Visit a lactation consultant. This type of nursing expert can help improve your newborns latch and offer helpful advice for boosting your little ones breastmilk intake. When babies dont get enough to eat in their first three to five days, they have a higher risk of jaundice. […] Keep follow-up appointments. Skin color alone is not a good way to tell if your newborns jaundice is getting worse! That means, always keep your follow-up appointments, and have any tests done that your pediatrician recommends.

• #16 Jaundice Defense: 6 Essential Tips for New Parents | Medanta

  https://www.medanta.org/patient-education-blog/6-tips-for-expecting-parents-to-safeguard-their-newborns-from-jaundice

  Regular prenatal check-ups are crucial for a healthy pregnancy. Healthcare experts can spot potential risks for neonatal jaundice and offer prevention advice. Managing the mother’s health is paramount because some of these can lead to jaundice in newborns. […] Breastfeeding is good for the baby’s health and helps prevent jaundice. Ensuring a proper latch and frequent feeding can prevent dehydration, a factor in elevated bilirubin levels. Expecting parents need education on effective breastfeeding techniques. […] Safe exposure to natural sunlight aids bilirubin breakdown. Placing the baby in indirect sunlight for short periods, like 10-15 minutes a few times a day, helps. It’s crucial to follow guidelines to prevent sunburn and dehydration. […] Educating parents about the signs of jaundice is key to early detection. Yellowing of the skin and eyes, poor feeding, and lethargy are common indicators. Regular healthcare visits for bilirubin level checks, especially in the first week after birth, can help catch any issues early on.

• #17 Newborn jaundice Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/newborn-jaundice

  In newborns, some degree of jaundice is normal and probably not preventable. The risk for serious jaundice can often be reduced by feeding babies at least 8 to 12 times a day for the first several days and by carefully identifying infants at highest risk. […] All pregnant women should be tested for blood type and unusual antibodies. If the mother is Rh negative, follow-up testing on the infant’s umbilical cord is recommended. This may also be done if the mother’s blood type is O positive. […] Careful monitoring of all babies during the first 5 days of life can prevent most complications of jaundice. This includes: […] Considering a baby’s risk for jaundice […] Checking bilirubin level in the first day or so […] Scheduling at least one follow-up visit the first week of life for babies sent home from the hospital in 72 hours.

• #18 Newborn jaundice Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/newborn-jaundice

  In newborns, some degree of jaundice is normal and probably not preventable. The risk for serious jaundice can often be reduced by feeding babies at least 8 to 12 times a day for the first several days and by carefully identifying infants at highest risk. […] All pregnant women should be tested for blood type and unusual antibodies. If the mother is Rh negative, follow-up testing on the infant’s umbilical cord is recommended. This may also be done if the mother’s blood type is O positive. […] Careful monitoring of all babies during the first 5 days of life can prevent most complications of jaundice. This includes: […] Considering a baby’s risk for jaundice […] Checking bilirubin level in the first day or so […] Scheduling at least one follow-up visit the first week of life for babies sent home from the hospital in 72 hours.

• #19 How to Prevent Jaundice in Newborns: 9 Steps (with Pictures)

  https://www.wikihow.com/Prevent-Jaundice-in-Newborns

  Jaundice, or hyperbilirubinemia, is a common medical condition that develops in newborns within the first two to four days of life. […] While there is no sure way to completely prevent jaundice, knowing risk factors can help you determine what you can do to prevent and prepare for newborn jaundice. […] Take blood tests during pregnancy. Certain blood incompatibilities can cause more blood cells to break down, producing more bilirubin. […] In addition to prenatal blood tests, doctors now routinely test the baby for jaundice before the baby leaves the hospital. […] Reduce the risk of a preterm birth. Babies born before 38 weeks are at an increased risk of developing jaundice. […] Keep up-to-date on your prenatal care. Early and consistent prenatal care will ensure that you and your baby stay as healthy as possible during the pregnancy, which can pinpoint any problems that could lead to premature delivery.

• #20 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Mothers must be advised to breastfeed their newborns at least 8-12 times a day in the first days (grade I recommendation). […] A programme for breastfeeding support should be established in every health care institution that manages deliveries, with continuation in primary care (evidence level 5, grade I recommendation). […] Newborns that lose more than 10% of their birth weight should be assessed by a professional with specific training in breastfeeding (evidence level 5, grade I recommendation). […] The early identification of newborns at risk of developing significant hyperbilirubinaemia is key for its prevention. […] Every newborn should be assessed for the risk of developing hyperbilirubinaemia before discharge. This assessment is particularly important in infants who are discharged before the age of 72h (grade I recommendation).

• #21 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  Mothers must be advised to breastfeed their newborns at least 8-12 times a day in the first days (grade I recommendation). […] A programme for breastfeeding support should be established in every health care institution that manages deliveries, with continuation in primary care (evidence level 5, grade I recommendation). […] Newborns that lose more than 10% of their birth weight should be assessed by a professional with specific training in breastfeeding (evidence level 5, grade I recommendation). […] The early identification of newborns at risk of developing significant hyperbilirubinaemia is key for its prevention. […] Every newborn should be assessed for the risk of developing hyperbilirubinaemia before discharge. This assessment is particularly important in infants who are discharged before the age of 72h (grade I recommendation).

• #22 Neonatal Jaundice Treatment & Management: Approach Considerations, Medical Care, Phototherapy

  https://emedicine.medscape.com/article/974786-treatment

  Prevention of severe neonatal jaundice is best achieved through attention to the risk status of the infant prior to discharge from the birth hospital, through parent education, and through careful planning of postdischarge follow-up. […] A predischarge bilirubin measurement, obtained by transcutaneous or serum measurement and plotted into an hour-specific nomogram, has been shown to be a useful tool in distinguishing infants with a low risk of subsequently developing high bilirubin values. […] Risk factors for development of neonatal jaundice as well as for bilirubin neurotoxicity have been discussed earlier.

• #23 Jaundice : neonatal guideline | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/jaundice-neonatal-guideline/

  Healthcare professionals should use every opportunity to assess infants for the development of visible jaundice. […] Higher risk babies should receive an additional inspection. […] If jaundice is visible then a bilirubin level must be measured using a transcutaneous bilirubinometer or serum testing. […] A serum bilirubin must be obtained in babies less than 35 weeks gestation or less than 24 hours old with visible jaundice. […] Visual estimation of the severity of jaundice is no longer acceptable. […] Arrangements should be made for identification of infants in these categories, and particular attention made to assessing for jaundice. If visible jaundice is noted by any member of staff prior to this additional check taking place then immediate action should be taken rather than awaiting this additional check.

• #24 Newborn jaundice | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice

  Jaundice is a common condition in newborn babies. […] Bilirubin is checked routinely on newborn babies to identify risk of jaundice. […] Some babies are treated while still in the hospital with light therapy. […] Babies who have severe jaundice must be treated quickly; otherwise, they can develop brain damage. […] If you’re breastfeeding, feed your baby when they’re hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. […] The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice after birth while in the hospital. […] The AAP recommends that babies be checked for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest.

• #25 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  The key to secondary prevention is vigilance on the part of the health care team. All hospitalized newborns should be routinely monitored by nursing staff and physicians for the development of jaundice every eight to 12 hours, including at the time that vital signs are taken. […] Newborns should be examined within 24 to 72 hours of hospital discharge to assess for jaundice and general well-being. […] Earlier follow-up (within 24 to 48 hours) should be instituted for infants with more risk factors for severe hyperbilirubinemia, shorter hospital stays, or predischarge bilirubin levels in the high-intermediate or high-risk zones. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #26 Jaundice : neonatal guideline | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/jaundice-neonatal-guideline/

  Healthcare professionals should use every opportunity to assess infants for the development of visible jaundice. […] Higher risk babies should receive an additional inspection. […] If jaundice is visible then a bilirubin level must be measured using a transcutaneous bilirubinometer or serum testing. […] A serum bilirubin must be obtained in babies less than 35 weeks gestation or less than 24 hours old with visible jaundice. […] Visual estimation of the severity of jaundice is no longer acceptable. […] Arrangements should be made for identification of infants in these categories, and particular attention made to assessing for jaundice. If visible jaundice is noted by any member of staff prior to this additional check taking place then immediate action should be taken rather than awaiting this additional check.

• #27 Jaundice : neonatal guideline | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/jaundice-neonatal-guideline/

  Healthcare professionals should use every opportunity to assess infants for the development of visible jaundice. […] Higher risk babies should receive an additional inspection. […] If jaundice is visible then a bilirubin level must be measured using a transcutaneous bilirubinometer or serum testing. […] A serum bilirubin must be obtained in babies less than 35 weeks gestation or less than 24 hours old with visible jaundice. […] Visual estimation of the severity of jaundice is no longer acceptable. […] Arrangements should be made for identification of infants in these categories, and particular attention made to assessing for jaundice. If visible jaundice is noted by any member of staff prior to this additional check taking place then immediate action should be taken rather than awaiting this additional check.

• #28 Newborn jaundice | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice

  Jaundice is a common condition in newborn babies. […] Bilirubin is checked routinely on newborn babies to identify risk of jaundice. […] Some babies are treated while still in the hospital with light therapy. […] Babies who have severe jaundice must be treated quickly; otherwise, they can develop brain damage. […] If you’re breastfeeding, feed your baby when they’re hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. […] The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice after birth while in the hospital. […] The AAP recommends that babies be checked for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest.

• #29 Jaundice : neonatal guideline | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/jaundice-neonatal-guideline/

  Healthcare professionals should use every opportunity to assess infants for the development of visible jaundice. […] Higher risk babies should receive an additional inspection. […] If jaundice is visible then a bilirubin level must be measured using a transcutaneous bilirubinometer or serum testing. […] A serum bilirubin must be obtained in babies less than 35 weeks gestation or less than 24 hours old with visible jaundice. […] Visual estimation of the severity of jaundice is no longer acceptable. […] Arrangements should be made for identification of infants in these categories, and particular attention made to assessing for jaundice. If visible jaundice is noted by any member of staff prior to this additional check taking place then immediate action should be taken rather than awaiting this additional check.

• #30 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  The key to secondary prevention is vigilance on the part of the health care team. All hospitalized newborns should be routinely monitored by nursing staff and physicians for the development of jaundice every eight to 12 hours, including at the time that vital signs are taken. […] Newborns should be examined within 24 to 72 hours of hospital discharge to assess for jaundice and general well-being. […] Earlier follow-up (within 24 to 48 hours) should be instituted for infants with more risk factors for severe hyperbilirubinemia, shorter hospital stays, or predischarge bilirubin levels in the high-intermediate or high-risk zones. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #31 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  The key to secondary prevention is vigilance on the part of the health care team. All hospitalized newborns should be routinely monitored by nursing staff and physicians for the development of jaundice every eight to 12 hours, including at the time that vital signs are taken. […] Newborns should be examined within 24 to 72 hours of hospital discharge to assess for jaundice and general well-being. […] Earlier follow-up (within 24 to 48 hours) should be instituted for infants with more risk factors for severe hyperbilirubinemia, shorter hospital stays, or predischarge bilirubin levels in the high-intermediate or high-risk zones. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #32 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html/1000

  Outpatient evaluation should include follow-up on weight, intake, voiding, and stooling. A TSB or TcB level should be obtained in the outpatient setting if jaundice is increasing or if the clinical assessment is unclear as to the severity of jaundice. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. Some institutions with such a protocol report a reduced proportion of neonates with hyperbilirubinemia, its complications, and subsequent hospitalizations. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #33 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html/1000

  Outpatient evaluation should include follow-up on weight, intake, voiding, and stooling. A TSB or TcB level should be obtained in the outpatient setting if jaundice is increasing or if the clinical assessment is unclear as to the severity of jaundice. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. Some institutions with such a protocol report a reduced proportion of neonates with hyperbilirubinemia, its complications, and subsequent hospitalizations. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #34 Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation | Anales de Pediatría

  https://analesdepediatria.org/en-guidelines-for-prevention-detection-management-articulo-S234128791730162X

  All hospitals should provide parents with written and verbal information at the time of discharge, which should include an explanation of jaundice and how to monitor infants for it (grade I recommendation). […] The identification of newborns at risk of developing significant hyperbilirubinaemia and the prevention of bilirubin encephalopathy continue to be public health priorities.

• #35 Preventing Jaundice in Newborns: Tips for McKinney Parents

  https://www.kidsvillepeds.com/blog/1267962-how-to-prevent-jaundice-in-newborns/

  Newborn jaundice typically appears within the first few days after birth, manifesting as a yellowish tint to the skin and eyes. […] One of the simplest and most effective ways to prevent jaundice is to ensure your baby feeds frequently. Breastfeeding 8-12 times a day during the first week helps stimulate bowel movements, which assist in eliminating bilirubin from the body. […] Parents should stay vigilant for early signs of jaundice, such as yellowing of the skin and eyes, lethargy, or poor feeding. Identifying these symptoms early allows for timely consultation with a pediatrician, reducing the risk of severe jaundice. […] Light therapy (phototherapy) is a common treatment for jaundice, but you can take preventative measures by exposing your baby to indirect sunlight. […] A good latch ensures your baby gets enough milk, which is vital for regular bowel movements.

• #36 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html/1000

  Outpatient evaluation should include follow-up on weight, intake, voiding, and stooling. A TSB or TcB level should be obtained in the outpatient setting if jaundice is increasing or if the clinical assessment is unclear as to the severity of jaundice. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. Some institutions with such a protocol report a reduced proportion of neonates with hyperbilirubinemia, its complications, and subsequent hospitalizations. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats.

• #37 Neonatal Hyperbilirubinemia – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/300_399/0332.html

  Aetna considers the following interventions, unless otherwise specified below, medically necessary when the following criteria are met: […] Prophylactic phototherapy is considered medically necessary for infants showing a rapid rise in bilirubin (greater than 1 mg/dL/hour) and as a temporary measure when one is contemplating exchange transfusion. […] According to available guidelines, inpatient treatment may be considered medically necessary for healthy full-term infants who present with a TSB greater than or equal to 20 mg/dL in the first post-natal week. […] A delay in discharge from the hospital in order to observe the infant for rebound once the bilirubin has decreased is not considered medically necessary. […] Management of physiologic hyperbilirubinemia in preterm infants (defined as an infant born prior to 37 weeks gestation) according to guidelines published by the AAP.

• #38 Newborn jaundice | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice

  If your baby has mild jaundice, her provider may recommend that you breastfeed your baby more often so to produce more bowel movements. This helps to get rid of bilirubin. […] Phototherapy treatment (also called light therapy or bili lights). This is when your baby is placed under special lights that help your baby’s body change bilirubin into a form that can exit the body in urine. […] If you can’t afford to have your baby treated with the special lights or blanket, your doctor may use indirect (filtered) sunlight to treat your baby’s jaundice. […] Intravenous immunoglobulin (also called IVIg). If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. […] Exchange transfusion. If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, your baby may need a special type of blood transfusion called an exchange transfusion.

• #39 Jaundice in babies | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/jaundice-in-babies

  Jaundice usually appears on the second or third day. […] Treatment isn’t usually necessary, unless the baby has very high bilirubin levels, or is premature or sick. […] Treatment for jaundice in babies depends on the cause, but may include: […] mild jaundice if the baby is otherwise healthy and well, no treatment is necessary. […] moderate jaundice phototherapy is the most common treatment. […] severe jaundice sometimes babies need treatment with more than one blue light at a time (multiple phototherapy). […] Treatment for common conditions that cause jaundice may include: […] physiological jaundice often no treatment required, occasionally phototherapy is needed […] breastmilk jaundice breastfeeding should be continued. […] blood group differences the antibodies made by the mother can remain active in the baby’s system for a few weeks.

• #40 Jaundice : neonatal guideline | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/jaundice-neonatal-guideline/

  Treatment should be commenced once a serum bilirubin has confirmed that the bilirubin level is over the treatment threshold. […] Use intravenous immunoglobulin (IVIG) (500 mg/kg over 4 hours) as an adjunct to continuous multiple phototherapy in cases of Rhesus haemolytic disease or ABO haemolytic disease when the serum bilirubin continues to rise by more than 8.5 micromol/litre per hour. […] Exchange transfusions are only performed with consultant approval.

• #41 Newborn jaundice | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice

  If your baby has mild jaundice, her provider may recommend that you breastfeed your baby more often so to produce more bowel movements. This helps to get rid of bilirubin. […] Phototherapy treatment (also called light therapy or bili lights). This is when your baby is placed under special lights that help your baby’s body change bilirubin into a form that can exit the body in urine. […] If you can’t afford to have your baby treated with the special lights or blanket, your doctor may use indirect (filtered) sunlight to treat your baby’s jaundice. […] Intravenous immunoglobulin (also called IVIg). If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. […] Exchange transfusion. If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, your baby may need a special type of blood transfusion called an exchange transfusion.

• #42 Does My Baby Have Jaundice? What Are the Treatments?

  https://www.webmd.com/parenting/baby/digestive-diseases-jaundice

  There isn’t much you can do to prevent the typical jaundice in newborns. But you can help move it along by being sure your baby is well fed. If you’re breastfeeding, aim for 8-12 feedings a day in the first days of your baby’s life. If you’re formula feeding, offer 1-2 ounces every 2-3 hours. Exposing your baby to sunlight also helps break down indirect bilirubin. Sit by the window indoors with your baby, or take your baby for a stroll in the stroller if it’s a nice day with sunshine.

• #43 How to Prevent Jaundice in Newborns: 9 Steps (with Pictures)

  https://www.wikihow.com/Prevent-Jaundice-in-Newborns

  Expose your baby to light. Ultraviolet light reacts with bilirubin, changing it into a form that does not need to pass through the liver in order to be expelled, thereby eliminating excess bilirubin from the body and reducing the risk of jaundice. […] Ensure that the baby does not become chilled while sunning by raising the temperature in the room and/or laying the baby across your own chest while sunning.

• #44 Sunlight for the prevention and treatment of hyperbilirubinemia in newborns | Cochrane

  https://www.cochrane.org/CD013277/NEONATAL_sunlight-prevention-and-treatment-hyperbilirubinemia-newborns

  Sunlight may be an effective adjunct to conventional phototherapy in LMIC settings, may allow for rotational use of limited phototherapy machines, and may be preferable to families as it can allow for increased bonding. […] Sunlight may be effective in preventing hyperbilirubinemia in some cases, but these studies have not demonstrated that sunlight alone is effective for the treatment of hyperbilirubinemia given its sporadic availability and the low or very low certainty of the evidence in these studies. […] One study of twice-daily sunlight exposure (30 to 60 minutes) compared to no treatment reported the incidence of jaundice may be reduced and the number of days that an infant was jaundiced may be reduced. […] Filtered-sunlight phototherapy (FSPT) and conventional or intensive electric phototherapy led to a similar number of days of effective treatment. […] Possible harms: both studies showed a probable increased risk for hyperthermia (body temperature greater than 37.5 C) with FSPT.

• #45

  https://journals.lww.com/greenjournal/fulltext/1972/07000/prophylaxis_of_neonatal_hyperbilirubinemia_with.15.aspx

  In an effort to lower the incidence and severity of neonatal jaundice, 96 mothers were each given 20 mg of phenobarbital each night, beginning at the thirty-second week of gestation. […] This study concludes that treating mothers with phenobarbital is an effective adjunct in lowering the incidence of neonatal jaundice.

• #46

  https://www.ijpediatrics.com/index.php/ijcp/article/view/400

  This study was performed to study the role of prophylactic phenobarbitone in preventing neonatal jaundice in babies with birth weight 1250 to 2400 gm and to study the incidence of neonatal jaundice, need for phototherapy and exchange transfusion in babies inspite of giving prophylactic phenobarbitone. […] Group I babies were given 10 mg/Kg loading dose of phenobarbitone within 6 hrs of life followed by maintenance dose of 5 mg/Kg/day intravenous from day 2 to day 5. […] Among group I, none of the babies (0%) required Exchange Transfusion whereas among group II, 4 babies (7.54%) required Exchange transfusion. […] No of babies who developed significant jaundice were low in Group I, day of appearance of significant level of jaundice was delayed in Group I, mean age of onset of significant level of jaundice was delayed in preterm babies compared to term babies, need for phototherapy and exchange transfusion were low in Group I.

• #47 Neonatal Hyperbilirubinemia – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/300_399/0332.html

  Home phototherapy for physiologic jaundice in healthy infants with a gestational age of 35 weeks or more if all of the following criteria are met: […] If levels do not respond by stabilizing (+/- 1 mg/dL) or declining, more intensive phototherapy may be warranted. […] The following interventions are considered experimental, investigational, or unproven because the effectiveness of these approaches has not been established: […] The authors concluded that the role of zinc in the prevention of neonatal hyperbilirubinemia is not supported by the current evidence. […] The authors concluded that current studies are unable to provide reliable evidence regarding the effectiveness of prebiotics on hyperbilirubinemia. […] The authors concluded that limited low-quality evidence indicated that probiotic supplementation may reduce the duration of phototherapy in neonates with jaundice. […] The authors concluded that the findings of this study did not support the UDCA use in the clinical practice. […] The authors concluded that fenofibrate might be a safe adjunct to neonatal PT.

• #48 Newborn Jaundice: Pathological, Prevention, Signs of Recovery

  https://www.medicinenet.com/newborn_jaundice_neonatal_jaundice/article.htm

  Is it possible to prevent jaundice in newborns? […] Some degree of jaundice in newborns is normal and not entirely preventable. However, the prevention of significant hyperbilirubinemia and its complications is possible through proper screening (obtaining bilirubin levels), identifying newborns at high risk, close surveillance, and monitoring of those infants with hyperbilirubinemia, parent education, and prompt treatment when deemed medically indicated.

• #49 Management of neonatal hyperbilirubinemia

  https://acutecaretesting.org/en/articles/management-of-neonatal-hyperbilirubinemia

  The updated 2004 AAP guidelines attempt to address these questions and recommend, by consensus, a systems approach which, if implemented by all birthing institutions, should prevent virtually all cases of kernicterus in term and near-term infants. […] The need for ongoing re-evaluation of clinical practice is rooted in a search for a safer approach to manage newborn hyperbilirubinemia in changing healthcare ecosystems. […] Consensus and evidence-based data indicate that a) kernicterus, based on a standardized definition, can almost always be prevented in term healthy infants; b) until we know the risk of unmonitored and untreated hyperbilirubinemia, a systems approach would be safer; and c) there is a need to define safe levels of bilirubin in healthy and sick infants. […] Every one of the cases reported from the Registry, including the fatalities, could have been prevented by the systems approach, based on the Hour-specific Bilirubin Nomogram suggested in our papers.

• #50 Newborn jaundice: Time for prevention?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2529433/

  Documentation of a predischarge transcutaneous and/or serum bilirubin in the first 72 h of life for all newborns, or before if there are any concerns. […] The practice of plotting bilirubin results on the predictive nomogram before discharge, based on age in hours and gestational age, to identify the at-risk population. […] Confirmation of follow-up with a health care professional skilled in the assessment of feeding issues and jaundice in newborns, within two or three days, for all infants discharged less than 48 h after birth. […] The establishment of community programs encouraging and supporting breastfeeding. […] Heightened awareness among treating physicians, other health care professionals and the general public will help in detecting jaundice earlier, and will ensure prompt diagnosis and treatment, with the goal of preventing severe hyperbilirubinemia and its long-term sequelae.

• #51 How to Help with Jaundice at Home | Newborn Jaundice Tips – Monadnock Community Hospital

  https://monadnockcommunityhospital.com/services/pediatrics/jaundice-and-your-newborn/

  It is important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5 days old, because this is usually when a babys bilirubin level is highest. […] Most jaundice requires no treatment. When treatment is necessary, placing your baby under special lights while he or she is undressed will lower the bilirubin level. […] Treatment can prevent the harmful effects of jaundice. […] Many parents are concerned about how to help with jaundice at home. If your newborn has mild jaundice, there are several steps you can take at home to help manage the condition. […] Ensure your baby gets plenty of sunlight exposure by placing them near a window with indirect sunlight for short periods. […] Frequent feedings are crucial; breastfeed your baby 8 to 12 times a day to help them pass bilirubin through their stools. […] Always consult your pediatrician before trying any home remedies for jaundice to ensure they are safe and appropriate for your baby’s condition.

• #52 Management of neonatal hyperbilirubinemia

  https://acutecaretesting.org/en/articles/management-of-neonatal-hyperbilirubinemia

  It needs to be emphasized that the approach we suggest has, in pilot studies, been highly effective in reducing the incidence of severe and dangerous hyperbilirubinemia and the need for exchange transfusion, without an increase in costs. […] The new 2004 AAP guidelines do not offer new treatment options for hyperbilirubinemia but focus on prevention of severe hyperbilirubinemia and emphasize patient safety.

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