All newborns should be screened for jaundice and closely monitored after hospital discharge according to the Canadian Paediatric Society.1 Following a review of the available literature, the Society concluded that severe hyperbilirubinemia in relatively healthy term or late preterm newborns (greater than 35 weeks' gestation) continues to carry the potential for complications and chronic sequelae from acute bilirubin encephalopathy. Careful assessment of the risk factors for hyperbilirubinemia, a systematic approach to the detection and follow-up of jaundice with the appropriate laboratory investigations, along with judicious phototherapy and exchange transfusion when indicated, are all essential to avoid these complications.1

The new guidelines recommend that either a total serum bilirubin (TSB) or a transcutaneous bilirubin (TcB) should be measured in all infants during the first 72 hours of life. If not required earlier because of clinical jaundice, a TSB should be obtained at the same time of metabolic screening. If the TSB concentration does not require immediate intervention, the results should be plotted on the predictive nomogram. The result of the TSB measurement, the time at which it was obtained and the zone should be recorded, and a copy should be given to the parents. Follow-up of the infant should be individualized according to the risk assessment.

For a complete list of the new recommendations, go to http://www.cps.ca/english/statements/FN/fn07-02.htm.

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