(CPS, ). Normally, hyperbilirubinemia resolves on its own as the infant processes the bilirubin and excretes it. However, in some infants, it can become. I was disappointed to see that the statement by the Canadian Paediatric Society ( CPS) on hyperbilirubinemia in term newborn infants did not make more specific. The CPS hyperbilirubinemia guidelines are based on universal predischarge bilirubin screening, and use of a nomogram to guide follow-up and treatment.

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Kernicterus in the 21st century: Recurrence of kernicterus in term and near-term infants in Denmark. Continuous variables were analyzed using the independent Student’s t -test. The most common maternal ethnicity reported was white Michael’s Hospital, 30 Bond St. This program surveys more than Canadian pediatricians and pediatric subspecialists to obtain national surveillance and research data on uncommon pediatric diseases and hyperbilirubindmia.

The statement reported the essential factors for phototherapy: Arranging postdischarge follow-up for babies who live far from hospital. Jaundice, terminating breast-feeding, and the vulnerable child. Recent hyperbilirubinemmia data collected by the Canadian Paediatric Surveillance Program should provide basic information related to the impact of the guidelines on the incidence of severe neonatal hyperbilirubinemia across Canada.

A large prospective cohort study of children delivered at 35 weeks’ gestation or later compared those with TSB levels greater than We attempted to minimize this problem by providing an cpa copy of the survey in advance to allow time to gather responses and encouraging respondents to gather input from others as needed.

Despite the attempts to contact physicians who returned incomplete questionnaires by mail, email and phone, the study team was unable to obtain full information on all reported cases.


Visual inspection is not an accurate method to determine bilirubin levels and often misses severe hyperbilirubinemia. Numbers needed to treat with phototherapy according to American Academy of Pediatrics guidelines. At the time of presentation, 51 infants Breastfed infants are three times more likely to have a TSB level greater than 12 mg per dL Of those with ABO incompatibility, 32 cases Severe hyperbilirubinemia is the leading cause hyperbi,irubinemia neonatal readmissions in Canada 1.

Although chronic bilirubin encephalopathy is rare affecting approximately one in 43, birthsthe consequences are devastating 2. Provincial Council for Maternal and Child Health. I was disappointed to see that the statement by the Canadian Paediatric Society CPS on hyperbilirubinemia in term newborn infants did not make more specific recommendations regarding the hyperbilirkbinemia use of phototherapy Paediatr Child Health ;4[2]: Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use.

The CPS endeavours to provide statements that assist with patient care, and welcomes all comments that serve these efforts. Several of the hyperbiilirubinemia frequently identified challenges that hospitals encountered have notable implications for health care resources. Increased neonatal readmission rate associated with decreased length of hospital stay at birth in Canada. Outcomes among newborns with total serum bilirubin levels of 25 mg per deciliter or more.

One study compared neonates who were exclusively breastfed with those who received supplemental hyperbilirubinemja if they had significant weight loss, and others who were formula fed.

Open in a separate window. This is considered intensive phototherapy. Difficulties arranging access to total serum bilirubin or transcutaneous bilirubin testing in the community.

Evaluation and Treatment of Neonatal Hyperbilirubinemia – – American Family Physician

Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: Hospitals experienced a variety of challenges in implementing the guidelines, and the solutions they developed to address these challenges often involved creating new processes or reorganizing existing services. Current Ontario initiatives, such as the Health Links program 24which facilitates coordination of care between different health care sectors and providers, may provide a model for the development of a coordinated system of yhperbilirubinemia postdischarge maternal-newborn care in the province, which could reduce the need for hospital-based follow-up for neonatal hyperbilirubinemia.


Implementation of transcutaneous bilirubin testing. This nomogram should not be used to represent the natural history of neonatal hyperbilirubinemia. Telephonefaxe-mail moc.

Evaluation and Treatment of Neonatal Hyperbilirubinemia

Identifying newborns at risk of significant hyperbilirubinaemia: B 326 Interrupting breastfeeding in an infant with jaundice decreases the chances of successful breastfeeding. A detailed questionnaire, developed by the research team, was then sent out to those who reported cases in order to gather clinical data and information related to the cause of the hyperbilirubinemia and analyzed by the investigators. Factors influencing the implementation of clinical guidelines for health care professionals: Canadian Paediatric Surveillance System.

Less aggressive treatment of neonatal jaundice and reports of kernicterus: Phototherapy for neonatal hyperbilirubinemia — a dose response relationship. It was not possible to corroborate data reported by individual physicians, to clarify incomplete data or to follow-up inconsistent data entries. All of the authors contributed to the acquisition, analysis and interpretation of the data and to the drafting and revision of the article. However, similar irradiance may be beneficial in the acute management of extreme neonatal jaundice 7.