The Term Infant with Problems: Diagnosis and Evaluation of Early Jaundice

The goal of the evaluation and treatment of jaundice (hyperbilirubinemia) in the newborn infant is to prevent the development of severe hyperbilirubinemia which could lead to kernicterus. The American Academy of Pediatrics has developed recommendations to help physicians and other health care professionals caring for newborns manage and treat jaundice. These recommendations include :

1. the promotion and support of successful breastfeeding,
2. the establishment of protocols for evaluation and treatment of jaundice in hospitalized newborns,
3. the measurement of serum bilirubin levels in infants jaundiced in the first 24 hours of life,
4. the interpretion of bilirubin levels according to the infant's age in hours. See Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Page 301.
5. the recognition that breastfed infants < 38 weeks gestation are at higher risk of the development of jaundice and require closer monitoring,
6. the assessment of all infants prior to newborn discharge for risk of severe hyperbilirubinemia,
7. that all parents receive information about jaundice,
8. the provision of outpatient follow-up based on age at discharge and other risk factors, and
9. the use of phototherapy or exchange transfusion when indicated ( AAP Jaundice, 2004 ).