Guideline updated for managing hyperbilirubinemia in newborns

In a clinical practice guideline revision issued by the American Academy of Pediatrics and published online Aug. 5 in Pediatrics, updated recommendations are presented for the management of hyperbilirubinemia in newborn infants ≥35 weeks of gestation.

In the updated guidance, Alex R. Kemper, M.D., M.P.H., from the Nationwide Children's Hospital in Columbus, Ohio, and colleagues note that an infant should have a direct antiglobulin test and the infant's blood type should be determined as soon as possible if the maternal antibody screen is positive or unknown. Oral supplementation with water or dextrose water is not recommended to prevent hyperbilirubinemia or decrease bilirubin concentrations. At least every 12 hours following delivery until discharge, all infants should be visually assessed for jaundice. For infants noted to be jaundiced <24 hours after birth, total serum bilirubin (TSB) or transcutaneous bilirubin (TcB) should be measured as soon as possible. The authors also present recommendations for the treatment of hyperbilirubinemia and postdischarge follow-up.

"Kernicterus is rare, but the impact on children and their families can be devastating," Kemper said in a statement. "The guideline provides clinicians, birthing centers, and hospitals with strategies to prevent the worst-case scenarios and to help educate families so they recognize the signs of jaundice and know when to follow-up with their pediatrician."

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