The 2022 AAP Newborn Jaundice Guideline: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation

Dr. Holmes presented the 2022 American Academy of Pediatrics Clinical Practice Guideline for Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. A large, diverse committee developed the guideline over eight years. Dr. Holmes emphasized that the guideline is only intended for U.S. hospital systems. The purpose is to prevent chronic bilirubin encephalopathy (CBE). CBE manifests as choreoathetosis, hearing loss, and only a mild IQ effect, and occurs at an average bilirubin of 40 mg/dL. Dr. Homes first talked through key action statements for prevention. She highlighted that identifying infants with hemolysis is critical. We should screen for maternal antibodies and obtain a Direct Antibody Test on the infant if the maternal blood type is unknown or AB+. We should screen for Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency in atypical cases. More research targeted toward identifying babies with G6PD deficiency is needed. Finally, identifying suboptimal intake hyperbilirubinemia (a new name for breastfeeding jaundice) and intervening early with supplementation and breastfeeding support is essential. Dr. Holmes then reviewed key action statements in the assessment. Evidence supports obtaining a bilirubin level in all infants within 24-48 hours of birth, prior to discharge. She outlined the use of transcutaneous versus serum bilirubin and discussed that rapid rates of rise could suggest hemolysis. She also reviewed changes to the neurotoxicity r...
Source: The Hospitalist - Category: Hospital Management Authors: Tags: Clinical Guidelines Liver Disease Neonatal Medicine Pediatrics Quality Improvement Source Type: research