Page 10 - 16Neonatal Jaundice_compressed

Neonatal jaundice

In all babies:
• check whether there are factors associated with an increased likelihood of developing
significant hyperbilirubinaemia soon after birth
• examine the baby for jaundice at every opportunity especially in the first 72 hours.
When looking for jaundice (visual inspection):
• check the naked baby in bright and preferably natural light
• examination of the sclerae, gums and blanched skin is useful across all skin tones.

Additional care
Ensure babies with factors associated with an increased likelihood of developing significant
hyperbilirubinaemia receive an additional visual inspection by a healthcare professional during
the first 48 hours of life.

Measuring bilirubin in all babies with jaundice
Do not rely on visual inspection alone to estimate the bilirubin level in a baby with jaundice.

How to measure the bilirubin level
When measuring the bilirubin level:
• use a transcutaneous bilirubinometer in babies with a gestational age of 35 weeks or more
and postnatal age of more than 24 hours
• if a transcutaneous bilirubinometer is not available, measure the serum bilirubin
• if a transcutaneous bilirubinometer measurement indicates a bilirubin level greater than
250 micromol/litre check the result by measuring the serum bilirubin
• always use serum bilirubin measurement to determine the bilirubin level in babies with
jaundice in the first 24 hours of life
• always use serum bilirubin measurement to determine the bilirubin level in babies less than
35 weeks gestational age
• always use serum bilirubin measurement for babies at or above the relevant treatment
threshold for their postnatal age, and for all subsequent measurements
• do not use an icterometer.
How to manage hyperbilirubinaemia
Use the bilirubin level to determine the management of hyperbilirubinaemia in all babies (see
threshold table (Section 1.3) and treatment threshold graphs (Section 1.6)).

Care of babies with prolonged jaundice
Follow expert advice about care for babies with a conjugated bilirubin level greater than
25 micromol/litre because this may indicate serious liver disease.

2