Investigating Prolonged Neonatal Jaundice: A Staged Approach is Superior and Conducive to Breastfeeding
- 6 Downloads
In 2010, the National Institute for Health and Care Excellence (NICE) published guidance (CG98) for managing jaundice in neonates aged ≤ 28-days . 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) .
A study from Glasgow, UK where 1.5% of 12,986 live births (n = 197) were referred for PJ assessment found no significant pathology . 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 .
In our secondary care centre with an average birth rate of 2300/year, PJ was investigated in all neonates who met the NICE CG98  criteria in a dedicated clinic. Following a formal...
Clinical Effectiveness Department, Torbay Hospital.
All the authors have contributed equally to the manuscript.
- 1.National Institute for Health and Clinical Excellence. Neonatal Jaundice. Clinical Guideline 98, 2010. https://www.nice.org.uk/guidance/cg98. Accessed 23 July 2019.
- 3.Paul SP, Beech G, Graham J. NICE Guidelines for prolonged neonatal jaundice—Cross-sectional survey of investigations performed in the NHS hospitals in England. BSPGHAN Annual Meeting Abstracts, 2019; 165–166. https://www.bspghan.org.uk/documents/BSPGHAN%20Abstract%20Book%202019. Accessed 23 July 2019.