Management of neonatal jaundice
Management is as follows:
- diagnosis and correction of any underlying abnormality is important
- fluid and caloric intake will prevent worsening jaundice
- unconjugated hyperbilirubinaemia may be treated with phototherapy or with exchange transfusion
- conjugated hyperbilirubinaemia due to obstruction would be treated with the appropriate management for the underlying condition. Phototherapy or exchange transfusion may be required depedning on level of hyperbilirubinaemia
- management options for hyperbilirubinaemia have been stated by NICE (1):
- monitoring, or,
- phototherapy, or,
- exchange transfusion
- NICE have issued guidance as to the levels of raised bilirubin and age of the neonate when each management strategy is indicated:
Age (hours) | Bilirubin measurement (micromol/litre) |
0 | > 100 |
6 | > 150 |
12 | > 200 |
18 | > 250 |
24 | > 300 |
30 | > 350 |
36 | > 400 |
42 | > 450 |
48 | > 450 |
54 | > 450 |
60 | > 450 |
66 | > 450 |
72 | > 450 |
78 | > 450 |
84 | > 450 |
90 | > 450 |
96+ | > 450 |
Reference:
- NICE. Jaundice in newborn babies under 28 days. Clinical guideline CG98. Published May 2010, last updated October 2023
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