BACKGROUND: Examination for and treatment of jaundice is one of the most common occurrences in neonatal medicine. Neonatal jaundice has a foundation in normal physiology, but may be exacerbated by a number of factors. Therapy is given because pronounced jaundice carries a risk for brain damage (kernicterus). Intervention limits for therapy continue to be debated, as the scientific basis suffers from obvious weaknesses. MATERIAL AND METHODS: The American Academy of Pediatrics recently published new guidelines for the management of hyperbilirubinaemia in newborns. The new guidelines differ in important aspects from those published in 1994. Several new elements in the guidelines are of interest to Norwegian paediatricians. RESULTS: The goal of the new guidelines is to reduce the incidence of severe jaundice and kernicterus in neonates. As opposed to the 1994 guidelines, the new guidelines provide specific advice on the management of moderately premature infants, infants with haemolysis, and sick infants. The importance of early risk assessment is stressed, as well as the need for individualized follow up after discharge. INTERPRETATION: The new AAP guidelines introduce important elements compared to the previous ones and should contribute to safer management of jaundiced neonates. Norwegian paediatricians will find useful information in the new guidelines.
BACKGROUND: Examination for and treatment of jaundice is one of the most common occurrences in neonatal medicine. Neonatal jaundice has a foundation in normal physiology, but may be exacerbated by a number of factors. Therapy is given because pronounced jaundice carries a risk for brain damage (kernicterus). Intervention limits for therapy continue to be debated, as the scientific basis suffers from obvious weaknesses. MATERIAL AND METHODS: The American Academy of Pediatrics recently published new guidelines for the management of hyperbilirubinaemia in newborns. The new guidelines differ in important aspects from those published in 1994. Several new elements in the guidelines are of interest to Norwegian paediatricians. RESULTS: The goal of the new guidelines is to reduce the incidence of severe jaundice and kernicterus in neonates. As opposed to the 1994 guidelines, the new guidelines provide specific advice on the management of moderately premature infants, infants with haemolysis, and sick infants. The importance of early risk assessment is stressed, as well as the need for individualized follow up after discharge. INTERPRETATION: The new AAP guidelines introduce important elements compared to the previous ones and should contribute to safer management of jaundiced neonates. Norwegian paediatricians will find useful information in the new guidelines.