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Neonatal jaundice

iii) What are the criteria/indications for starting and stopping phototherapy in babies with
neonatal hyperbilirubinaemia?
iv) What is the correct procedure of giving phototherapy?
Focus on the method of feeding/types of feed, incubator/bassinet care, effect of intermittent
versus constant method on maternal–infant bonding, parental anxiety

Q6. Is it beneficial to give additional fluids (cup feeds, fluids) during treatment with
phototherapy?
What is the effectiveness of nutritional support and/or rehydration during treatment with
phototherapy in babies with neonatal hyperbilirubinaemia?
a) Oral – top milk feeds by bottle/cup/spoon or other liquids (water/juice)
b) Parenteral – IVF

Q7. Exchange transfusion
i) How effective is exchange transfusion?
ii) What is the best method (single volume versus double volume exchange)?
iii) What are the criteria/indications for carrying out an exchange transfusion?

Q8. What are the other ways of treating hyperbilirubinaemia? Are they effective?
What is the effectiveness of the following interventions in treating neonatal
hyperbilirubinaemia/preventing kernicterus?
a) Metalloporphyrins
b) Gammaglobulins
c) Drugs (phenobarbitol, clofibrate, cholestyramine)
d) Agar, charcoal
e) Suppositories, other rectal modes of treatment
f) Complementary/alternative medicines (Chinese herbal remedies such as Yin-chen)

IV. Monitoring and follow-up

Q9. How to monitor a baby with jaundice?
i) What are the appropriate criteria for monitoring (timing, frequency) of babies with jaundice
who are at lower risk of developing neonatal hyperbilirubinaemia/kernicterus?
ii) What are the appropriate criteria for monitoring (timing, frequency) of babies diagnosed with
neonatal hyperbilirubinaemia who do not require immediate treatment?

Q10. When to discharge a baby treated for hyperbilirubinaemia? What follow-up is
required?

i) What is the appropriate criterion for discharge of babies treated for neonatal
hyperbilirubinaemia?
ii) What is the appropriate timing/frequency of follow-up?

V. Information

Q11. What information and support should be given to parents/carers of babies with
neonatal hyperbilirubinaemia?
a) At the time of birth
b) At the time of recognition of jaundice (FOR ALL BABIES)
c) At the time of formal assessment/diagnosis
d) During monitoring
e) During treatment with phototherapy and other interventions
f) At discharge and follow-up

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