PERSPECTIVE
Hyperbilirubinaemia
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
Are they applicable in Britain?
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.
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
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This article has been cited by other articles:
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Kirk, J. M
(2008). Neonatal jaundice: a critical review of the role and practice of bilirubin analysis. Ann Clin Biochem
45: 452-462
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- AAP Guidelines for detecting neonatal hyperbilirubinemia and preventing kernicterus
- M.Jeffrey Maisels
- Fetal Neonatal Ed. Online, 2 Nov 2005 [Full text]
- Author's reply to Maisels
- Donal J Manning
- Fetal Neonatal Ed. Online, 14 Nov 2005 [Full text]
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