LLLI
Center for Breastfeeding Information
Journal Abstract of the Month for
September 2004
"Management of Hyperbilirubinemia
in the Newborn Infant 35 or More Weeks of Gestation"
Author:
AAP Subcommittee on Hyperbilirubinemia:
M. Jeffrey Maisels, MB, BCh
Richard D. Baltz, MD
Vinod K. Bhutani, MD
Thomas B. Newman, MD, MPH
Heather Palmer, MB, BCh
Warren Rosenfeld, MD
David K. Stevenson, MD
Howard B. Weinblatt, MD
Pediatrics 2004
July; 114(1):297-316
Jaundice occurs in most newborns
and most is benign. The focus of this clinical practice guideline is
to reduce the incidence of severe hyperbilirubinemia. In every infant
it is recommended that clinicians promote and support successful breastfeeding.
It is important to recognize that infants at less than 38 weeks’
gestation, particularly those who are breastfed, are at higher risk
of developing hyperbilirubinemia and will require closer surveillance
and monitoring. Clinicians should advise mothers to nurse their infants
at least 8 to 12 times per day. Providing appropriate support and advice
to breastfeeding mothers increases the likelihood that breastfeeding
will be successful. The AAP recommends against supplementation of nondehydrated
breastfed infants with water or dextrose water because the evidence
shows that it harms not benefits. The adequacy of intake should be evaluated
and the infant monitored if the weight loss is more than 10%. Evidence
of adequate intake in breastfed infants also includes at least 4 wet
diapers in 24 hours, and the passage of 3 to 4 stools per day, by the
fourth day. By the third to fourth day most stools in adequately breastfed
infants are changing from meconium to a mustard yellow stool. This assessment
will help to identify the breastfed infants that are at risk of dehydration
because of inadequate intake. Supplementation with expressed breast
milk is appropriate if the infant’s intake seems inadequate. Kernicterus
should be largely preventable if health care personnel follow the recommendations
listed in this guideline.
This paper is being categorized
with the following keyword:
Jaundice
To view this Clinical Practice
Guideline on the Management of Hyperbilirubinemia go to this link on
the American Academy of Pediatrics (AAP) Web site:
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;114/1/297
Page last edited Sun Oct 14 09:34:23 UTC 2007.
