Page 14 - 16Neonatal Jaundice_compressed

Neonatal jaundice

ID Recommendations See Chapter/Section
Information for parents or carers on treatment

17 Offer parents or carers information about treatment for 8
hyperbilirubinaemia, including:
• anticipated duration of treatment
• reassurance that breastfeeding, nappy-changing and cuddles can usually
continue.

18 Encourage mothers of breastfed babies with jaundice to breastfeed 8
frequently, and to wake the baby for feeds if necessary.
19 Provide lactation/feeding support to breastfeeding mothers whose baby is 8
visibly jaundiced.

How to manage hyperbilirubinaemia
20 Use the bilirubin level to determine the management of 7.1.1
hyperbilirubinaemia in all babies (see threshold table (Section 1.3) and
treatment threshold graphs (Section 1.6)).
21 Do not use the albumin/bilirubin ratio when making decisions about the 6.1
management of hyperbilirubinaemia.

22 Do not subtract conjugated bilirubin from total serum bilirubin when 6.1
making decisions about the management of hyperbilirubinaemia (see
management thresholds in the threshold table (Section 1.3) and treatment
threshold graphs (Section 1.6)).

Measuring and monitoring bilirubin thresholds during phototherapy
Starting phototherapy
23 Use serum bilirubin measurement and the treatment thresholds in the 7.1.2
threshold table (Section 1.3) and treatment threshold graphs (Section 1.6)
when considering the use of phototherapy.
24 In babies with a gestational age of 38 weeks or more whose bilirubin is in 7.1.2
the ‘repeat bilirubin measurement’ category in the threshold table
(Section 1.3) repeat the bilirubin measurement in 6–12 hours.
25 In babies with a gestational age of 38 weeks or more whose bilirubin is in 7.1.2
the ‘consider phototherapy’ category in the threshold table (Section 1.3)
repeat the bilirubin measurement in 6 hours regardless of whether or not
phototherapy has subsequently been started.
26 Do not use phototherapy in babies whose bilirubin does not exceed the 7.1.2
phototherapy threshold levels in the threshold table (Section 1.3) and
treatment threshold graphs (Section 1.6).
During phototherapy
27 During phototherapy: 7.1.2
• repeat serum bilirubin measurement 4–6 hours after initiating
phototherapy
• repeat serum bilirubin measurement every 6–12 hours when the serum
bilirubin level is stable or falling.

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