(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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Incidence and causes of severe neonatal hyperbilirubinemia in Canada

hyperbilirubinnemia Insights about the process and impact of implementing nursing guidelines on delivery of care in hospitals and community settings.

Release of Canadian Paediatric Society guidelines.

A handout on this topic is available at https: Better patient care through better value from our health care dollars. Visual inspection is not an accurate method to determine bilirubin levels and often misses severe hyperbilirubinemia.

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The American Academy of Pediatrics recommends promoting breastfeeding for infants with jaundice, assessing for the adequacy of breastfeeding, and increasing the frequency to eight to 12 times per day. The findings provide valuable insight into the impact of a complex paediatric guideline in the largest Canadian province. A monthly check-off form was mailed to participants asking them to return the form to the CPSP regardless of whether or not they identified a new case.


Kernicterus in otherwise healthy, breast-fed term newborns. Breast-feeding, neonatal jaundice and kernicterus.

Implementation of transcutaneous bilirubin testing. Predicting kernicterus in severe unconjugated hyperbilirubinemia.

Universal screening may also increase rates of phototherapy, sometimes inappropriately. Age of readmission for discharged infants.

Evaluation and Treatment of Neonatal Hyperbilirubinemia

Another response indicated that babies under midwifery care would be provided follow-up in the community by their midwife. Brethauer M, Carey L.

The median age of readmission was 5 days range 1—19 days Fig. Author information Copyright and License information Disclaimer.

Evaluation and Treatment of Neonatal Hyperbilirubinemia – – American Family Physician

Acknowledgments We thank Danielle Grenier for her ongoing advice and support during the project, Kinsley Jin for data collection and Kathleen Hollamby for administrative assistance. The impact of these guidelines has not been evaluated. Isr Med Assoc J. Guideline adherence, Hyperbilirubinemia, Jaundice, Practice hyperbilirubinemis. Additional research is needed to determine the impact that the guidelines have had on clinical outcomes and the hyperbilirubimemia of health services.


Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy.

Younger gestational age and exclusive breastfeeding are the strongest risk factors for the development of hyperbilirubinemia. Cases of kernicterus continue to be reported worldwide. Guidelines for phototherapy in hospitalized infants delivered at 35 or more weeks’ gestation.

Michael Sgro, Department of Paediatrics, St.

Re: Management of hyperbilirubinemia in term newborn infants

Jaundice, terminating breast-feeding, and the vulnerable child. Can Hyperbilirubijemia Public Health ; Severe hyperbilirubinemia is the leading cause of neonatal readmissions in Canada 1. Can J Neurol Sci ; Arrangements for outpatient follow-up via existing locations paediatric department, mother-baby unit, breastfeeding clinics.

Preventive Services Task Force, and the Canadian Task Force on Preventive Health Care were searched using the key terms neonatal hyperbilirubinemia, neonatal jaundice, maternal experience, and breastfeeding and jaundice. Universal screening for neonatal hyperbilirubinemia is controversial. N Engl J Med. Interpretation Severe neonatal hyperbilirubinemia continues to occur frequently in Canada.

C 5 Phototherapy decreases the hyperbilirubijemia for exchange transfusion in newborns with severe hyperbilirubinemia. Provincial Council for Maternal and Child Health.