Diagnosis and management of hyperbilirubinemia in the term neonate: for a safer first week

Pediatr Clin North Am. 2004 Aug;51(4):843-61, vii. doi: 10.1016/j.pcl.2004.03.011.


New data support restructuring the approach toward diagnosis and management of hyperbilirubenia in the term neonate to make it more physician-friendly and gain wider implementation. The authors advocate clear criteria for patient safety, preventive approaches, and timely interventions. Structural changes to facilitate a system-based approach should include predischarge bilirubin management; follow-up bilirubin management; and lactational support and nutritional management. The authors advocate total serum bilirubin screening and a scoring system based on clinical risk factors as predischarge screening strategies; we should screen all babies for hyperbilirubinemia and for targeted follow-up based on an hour-specific total serum bilirubin measured for risk assessment. We should also provide focused universal education emphasizing adequate lactational nutrition, to decrease severe hyperbilirubinemia and thus prevent kernicterus.

Publication types

  • Review

MeSH terms

  • Exchange Transfusion, Whole Blood / adverse effects
  • Humans
  • Hyperbilirubinemia / diagnosis*
  • Hyperbilirubinemia / epidemiology
  • Hyperbilirubinemia / physiopathology
  • Hyperbilirubinemia / therapy*
  • Infant, Newborn
  • Kernicterus / diagnosis
  • Kernicterus / prevention & control
  • Kernicterus / therapy
  • Practice Guidelines as Topic
  • Severity of Illness Index
  • United States / epidemiology