Neonatal Jaundice Management  -  AAP Guideline
Management AAP Guideline		The AAP published in July, 2004 a Clinical Practice Guideline entitled "Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation". It represents a major update of the previous 1994 Practice Parameter on Management of Neonatal Hyperbilirubinemia. It acknowledges that kernicterus is still occurring but strongly suggests that "if health care personnel follow the recommendations listed in this guideline, kernicterus would be largely preventable." The recommendations in the guideline are all evidence-based. They follow JCAHO's and the Institute of Medicine's principles of patient safety and timeliness of intervention to prevent adverse outcomes. They emphasize the importance of "universal systematic assessment for the risk of severe hyperbilirubinemia, close follow-up and prompt intervention when indicated." They also specify the importance of educational materials for parents. The key elements of the guidelines have been collated separately. The specific recommendations are as follows: Promote and support successful breastfeeding Assess risk in the hospital of developing severe hyperbilirubinemia Measure bilirubin if jaundiced in first 24 hours Seek cause of jaundice if under phototherapy or bilirubin rising rapidly Assess risk at discharge of developing severe hyperbilirubinemia Provide information to parents and assure adequate follow-up Follow recommendations for treatment with phototherapy and/or exchange transfusion Return to top of page