Page 9 - 16Neonatal Jaundice_compressed

1 Guidance summary

1.1 Key terms

Conventional phototherapy Phototherapy given using a single light source (not fibreoptic)
that is positioned above the baby
Direct Antiglobulin Test (DAT) Also known as the direct Coombs’ test; this test is used to
detect antibodies or complement proteins that are bound to
the surface of red blood cells
Fibreoptic phototherapy Phototherapy given using a single light source that comprises a
light generator, a fibre-optic cable through which the light is
carried and a flexible light pad, on which the baby is placed or
that is wrapped around the baby
Multiple phototherapy Phototherapy that is given using more than one light source
simultaneously; for example, two or more conventional units,
or a combination of conventional and fibreoptic units
Near-term 35 to 36 weeks gestational age
Preterm Less than 37 weeks gestational age
Prolonged jaundice Jaundice lasting more than more than 14 days in term babies
and more than 21 days in preterm babies
Significant hyperbilirubinaemia An elevation of the serum bilirubin to a level requiring
treatment
Term 37 weeks or more gestational age
Visible jaundice Jaundice detected by a visual inspection

1.2 Key priorities for implementation

Information for parents and carers
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.

Care for all babies
Identify babies as being more likely to develop significant 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.

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