Page 12 - 16Neonatal Jaundice_compressed

Neonatal jaundice

1.4 Summary of all recommendations

ID Recommendations See Chapter/Section

Information for parents and carers
1 Offer parents or carers information about neonatal jaundice that is tailored 8
to their needs and expressed concerns. This information should be
provided through verbal discussion backed up by written information.
Care should be taken to avoid causing unnecessary anxiety to parents or
carers. Information should include:
• factors that influence the development of significant
hyperbilirubinaemia
• how to check the baby for jaundice
• what to do if they suspect jaundice
• the importance of recognising jaundice in the first 24 hours and of
seeking urgent medical advice
• the importance of checking the baby’s nappies for dark urine or pale
chalky stools
• the fact that neonatal jaundice is common, and reassurance that it is
usually transient and harmless
• reassurance that breastfeeding can usually continue.

Care for all babies
2 Identify babies as being more likely to develop significant 3.1
hyperbilirubinaemia if they have any of the following factors:
• gestational age under 38 weeks
• a previous sibling with neonatal jaundice requiring phototherapy
• mother’s intention to breastfeed exclusively
• visible jaundice in the first 24 hours of life.
3 Ensure that adequate support is offered to all women who intend to 3.1
*
breastfeed exclusively
4 In all babies: 5.1
• 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.

5 Parents, carers and healthcare professionals should all look for jaundice 5.1
(visual inspection).
6 When looking for jaundice (visual inspection): 5.1
• check the naked baby in bright and preferably natural light
• examination of the sclerae, gums and blanched skin is useful across all
skin tones.

7 Do not rely on visual inspection alone to estimate the bilirubin level in a 5.1
baby with jaundice.
8 Do not measure bilirubin levels routinely in babies who are not visibly 4.1
jaundiced.

* Refer to ‘Routine postnatal care of women and their babies’ (NICE clinical guideline 37) for information on breastfeeding support.

4