HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in ADC Online Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Manning, D Search for Related Content PubMed PubMed Citation Articles by Manning, D Related Collections Pancreas and biliary tract Guidelines Perinatal

American Academy of Pediatrics guidelines for detecting neonatal hyperbilirubinaemia and preventing kernicterus

Correspondence to:
Correspondence to:
Dr Manning
Wirral Hospital, Arrowe Park, Wirral, Merseyside CH49 5PE, UK; donal.manning@whnt.nhs.uk

Keywords: jaundice; hyperbilirubinaemia; bilirubin encephalopathy; kernicterus

The first 150 words of the full text of this article appear below.

In 2004 the American Academy of Pediatrics (AAP) revised its guidelines for management of severe hyperbilirubinaemia in the newborn.¹ The objective was to strike a balance between preventing severe hyperbilirubinaemia and its sequelae on the one hand and minimising overinvestigation and treatment of physiological jaundice on the other.

BACKGROUND TO THE REVISION OF THE 1994 GUIDELINES
The previous guidelines, published in 1994,² reflected a "kinder, gentler" approach to neonatal jaundice.³ Thanks to improvements in the management of rhesus isoimmunisation, bilirubin encephalopathy and kernicterus had virtually disappeared among term infants in the western world. Many paediatricians were concerned that this experience was extrapolated inappropriately to neonatal jaundice in general, and that infants with physiological and breast milk jaundice were undergoing unnecessary investigation and treatment. The 1994 guidelines were directed to reducing such intervention. They included the recommendation, however, that all infants discharged within 48 hours of birth should be followed up within three days.

Increasingly early postnatal discharge . . . [Full text of this article]

eLetters: