Page 175 - 16Neonatal Jaundice_compressed

Neonatal jaundice

information that addresses maternal responsibilities, management, potential effects of jaundice
and its treatment, anticipated duration of jaundice, and what mothers can do for their babies,
both pre-emptively and after jaundice has appeared.
The GDG suggests that increasing awareness of jaundice in prenatal classes and on postnatal
wards will empower and support mothers of newborn babies. Timely information and support
throughout the monitoring and treatment process will help to allay parental anxiety.

Recommendations – 8 Informaton

Offer parents or carers information about neonatal jaundice that is tailored 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.

Offer parents or carers information about treatment for hyperbilirubinaemia, including:
• anticipated duration of treatment
• reassurance that breastfeeding, nappy-changing and cuddles can usually continue.
Encourage mothers of breastfed babies with jaundice to breastfeed frequently, and to wake
the baby for feeds if necessary.
Provide lactation/feeding support to breastfeeding mothers whose baby is visibly jaundiced
Offer parents or carers verbal and written information on phototherapy including all of the
following:
• why phototherapy is being considered
• why phototherapy may be needed to treat significant hyperbilirubinaemia
• the possible adverse effects of phototherapy
• the need for eye protection and routine eye care
• reassurance that short breaks for feeding, nappy changing and cuddles will be encouraged
• what might happen if phototherapy fails
• rebound jaundice
• potential long-term adverse effects of phototherapy
• potential impact on breastfeeding and how to minimise this.

Offer parents or carers information on exchange transfusion including:
• the fact that exchange transfusion requires that the baby be admitted to an intensive care
bed
• why an exchange transfusion is being considered
• why an exchange transfusion may be needed to treat significant hyperbilirubinaemia
• the possible adverse effects of exchange transfusions
• when it will be possible for parents or carers to see and hold the baby after the exchange
transfusion.
Offer parents or carers information on IVIG including:
• why IVIG is being considered
• why IVIG may be needed to treat significant hyperbilirubinaemia
• the possible adverse effects of IVIG
• when it will be possible for parents or carers to see and hold the baby.

144