Page 19 - 16Neonatal Jaundice_compressed

Guidance summary

ID Recommendations See Chapter/Section
Other therapies

56 Do not use any of the following to treat hyperbilirubinaemia: 7.4
• agar
• albumin
• barbiturates
• charcoal
• cholestyramine
• clofibrate
• D-penicillamine
• glycerin
• manna
• metalloporphyrins
• riboflavin
• traditional Chinese medicine
• acupuncture
• homeopathy.

1.5 Research recommendations

1.5.1 Key priorities for research

What are the factors that underlie the association between breastfeeding and jaundice?
Why this is important
Evidence: Breastfeeding has been shown to be a factor in significant hyperbilirubinaemia. The
reasons for this association have not yet been fully elucidated. Population: Infants in the first
28 days of life. Exposure: Feeding type (breast milk, formula feeds or mixed feeds). Comparison:
Infants who do not develop significant hyperbilirubinaemia will be compared with infants with
significant hyperbilirubinaemia. Outcome: Factors to be analysed include I) maternal factors, II)
neonatal factors, III) blood analyses. Time stamp: Sept 2009

What is the comparative effectiveness and cost-effectiveness of universal pre-discharge
transcutaneous bilirubin screening alone or combined with a risk assessment in reducing
jaundice-related neonatal morbidity and hospital readmission?
Why this is important
Evidence: There is good evidence that a risk assessment that combines the result of a timed
transcutaneous bilirubin level with risk factors for significant hyperbilirubinaemia is effective at
preventing later significant hyperbilirubinaemia.Population: Babies in the first 28 days of life.
Subgroups should include near-term babies and babies with dark skin tones. Exposure: A/ Timed
pre-discharge transcutaneous bilirubin level. B/ Timed pre-discharge transcutaneous bilirubin
level combined with risk assessment. Comparison: Standard care (discharge without timed
transcutaneous bilirubin level). Outcome: i) Significant hyperbilirubinaemiaii) Cost-
effectiveness, III) Parental anxiety. Time stamp: Sept 2009

What is the comparative accuracy of the Minolta JM-103 and the BiliChek when compared to
serum bilirubin levels in all babies?
Why this is important
Evidence: The accuracy of transcutaneous bilirubinometers (Minolta JM-103 and BiliChek) has
been adequately demonstrated in term babies below treatment levels (bilirubin
< 250 micromol/litre). New research is needed to evaluate the accuracy of different
transcutaneous bilirubinometers in comparison to serum bilirubin levels in all babies.
Population: Babies in the first 28 days of life. Subgroups to include preterm babies, babies with
dark skin tones, babies with high levels of bilirubin and babies after phototherapy. Exposure:
Bilirubin levels taken from different transcutaneous bilirubinometers. Comparison: Bilirubin

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