AAP Clinical Practice Guidelines: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation

Abstract:

Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment. Although kernicterus should almost always be preventable, cases continue to occur. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeeding; 2) perform a systematic assessment before discharge for the risk of severe hyperbilirubinemia; 3) provide early and focused follow-up based on the risk assessment; and 4) when indicated, treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia and, possibly, bilirubin encephalopathy (kernicterus).

More resources:

AM Report PPT

AAP Handout on Jaundice for Parents

GCN InfoCard (includes Bhutani nomogram ©AAP)

NeoReview™ of transcutaneuos bilirubinometry

National Newborn Screening and Genetics Resource Center

Case:

You are seeing a 2-month old infant in your practice who just moved to Texas from Nevada. Where on the Internet can you go to determine what newborn screening tests are routinely done in Nevada?

Answer:

National Newborn Screening and Genetics Resource Center  (click above)

About NNSGRC:

Provides information and resources about newborn screening and genetics for health professionals, the public health community, consumers and government officials.

CDC National Center on Birth Defects and Developmental Disabilities

Provides information on birth defects and surveillance.