PATHOLOGICAL JAUNDICE NEWBORN SKIN

PATHOLOGICAL JAUNDICE NEWBORN SKIN

examination of the sclerae, gums and blanched skin is useful across all skin tones.check the naked baby in bright and preferably natural light.When looking for jaundice (visual inspection): examine the baby for jaundice at every opportunity especially in the first 72 hours.Visual estimation of the severity of jaundice is no longer acceptable.A serum bilirubin must be obtained in babies less than 35 weeks gestation or less than 24 hours old with visible jaundice.If jaundice is visible then a bilirubin level must be measured using a transcutaneous bilirubinometer or serum testing.Higher risk babies should receive an additional inspection.Healthcare professionals should use every opportunity to assess infants for the development of visible jaundice.Separate guidance on management of infants over 2 weeks old is contained in the prolonged jaundice section further into this document. This section gives guidance on the management of jaundice noted in the first two weeks of life. This document attempts to address these issues in a practical manner. Whilst there is no statutory obligation to follow NICE guidance in Scotland, it was felt that local guidance should be developed that ensured that practice was not too divergent from that described. This has been the source of a great deal of discussion, with divergent opinions some praising the approach 2 for its thoroughness, others stating concerns that it is too permissive 3 and many being concerned about the practicalities of implementing the guidance in disparate healthcare settings. This gives detailed recommendations for recognition and management of neonatal jaundice. NICE has produced guidance for England and Wales on this subject 1.

This is set against the occasional but devastating complication of kernicterus (with its long term implications) in those who are more severely affected.Д«alancing the desire to avoid excessive intrusive investigations for the healthy majority against attempts to capture those who would go on to develop kernicterus if untreated is a significant challenge. Mild jaundice is a common and usually harmless feature of the neonatal period, seen on a daily basis by staff in a huge variety of settings. The management of neonatal jaundice is a particular challenge to the neonatologist.

Pathological jaundice newborn