neonatal_jaundice_flashcards
What is a non-invasive method of measuring bilirubin in neonates?
Transcutaneous bilirubin.
When is transcutaneous bilirubin used?
As a screening test for babies with a relatively low risk of pathological jaundice (jaundice started >24 hours or born >35 weeks).
When is serum bilirubin used?
In neonates at a higher risk of pathological jaundice (jaundice <24 hours of age onset or born <35 weeks).
What additional tests should be considered if jaundice presents more than 2 weeks after birth?
TSH, LFTs, split bilirubin.
What is the management for physiological jaundice?
Reassurance and observation.
How is pathological unconjugated jaundice managed?
Using the serum bilirubin threshold graph, phototherapy as first-line treatment, intensified phototherapy and adjuncts (e.g., IVIG) as second-line treatments, and exchange transfusion for values above the upper red line.
When is phototherapy used in pathological unconjugated jaundice?
For values between the lower blue line and upper red line on the serum bilirubin threshold graph.
When is exchange transfusion used in pathological unconjugated jaundice?
For values above the upper red line on the serum bilirubin threshold graph.
How is pathological conjugated jaundice managed?
Treat the underlying cause, e.g., surgery for biliary atresia.
What is the management for breast milk jaundice?
Breastfeeding can usually continue as normal, use bilirubin levels to direct management.
What should parents be told about neonatal jaundice?
Neonatal jaundice is common. If <1 day or >14 days, the cause will be investigated. Physiological jaundice happens due to immature liver enzymes.
What is the treatment for neonatal jaundice?
Light therapy (phototherapy).
Is light therapy harmful to the baby?
No, but the baby’s eyes will be protected, and blood samples will need to be taken regularly.
What advice should be given about breastfeeding during neonatal jaundice?
Encourage frequent breastfeeding (e.g., every 3 hours) and wake the baby up to feed.
What needs to be checked after phototherapy has stopped?
Rebound hyperbilirubinaemia.
