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The increase in breast-feeding rates, the trend toward shorter hospital stays for newborns, and concern that the number of cases of kernicterus may be rising have led the AAP to release a comprehensive guideline that focuses on the detection and management of hyperbilirubinemia in newborn infants with gestational ages of ≥35 weeks. The guideline is lengthy, with numerous appendices. Some highlights:
Nurseries should have standard protocols for the detection of hyperbilirubinemia. Jaundice usually begins in the face and progresses caudally, but visual estimation can be inaccurate. Measuring bilirubin levels in all infants prior to discharge is one option.
Bilirubin levels should be plotted on a nomogram based on the age of the infant in hours …