Investigating Prolonged Neonatal Jaundice: A Staged Approach is Superior and Conducive to Breastfeeding

  • Jonathan Wayland Graham
  • Siba Prosad PaulEmail author
  • Sarah Mulholland
  • Steven Chi Tran
  • Charlotte Louise Butler
  • Rowan Douglas Mankiewitz
  • Georgia Beech
Letter to the Editor

Dear Editor,

In 2010, the National Institute for Health and Care Excellence (NICE) published guidance (CG98) for managing jaundice in neonates aged ≤ 28-days [1]. It recommended an extensive set of investigations for prolonged jaundice (PJ): conjugated bilirubin, full blood count, blood group determination and Coombs’ test, urine culture and verification of newborn metabolic screening (e.g. congenital hypothyroidism) [1].

A study from Glasgow, UK where 1.5% of 12,986 live births (n = 197) were referred for PJ assessment found no significant pathology [2]. Following the introduction of a rationalised investigation algorithm (split bilirubin and glucose-6-phosphate dehydrogenase [G6PD] where ethnically appropriate), the number of repeat investigations and return appointments significantly decreased [2].

In our secondary care centre with an average birth rate of 2300/year, PJ was investigated in all neonates who met the NICE CG98 [1] criteria in a dedicated clinic. Following a formal...



Clinical Effectiveness Department, Torbay Hospital.

Author Contribution

All the authors have contributed equally to the manuscript.




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Copyright information

© Association of Clinical Biochemists of India 2019

Authors and Affiliations

  1. 1.Department of PaediatricsTorbay HospitalTorquayUK
  2. 2.Peninsula Medical SchoolUniversity of PlymouthPlymouthUK

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