Universal screening and prompt follow-up essential to reducing debilitating jaundice among newborns, paediatricians say



    OTTAWA, June 14 /CNW Telbec/ - All newborns should be screened for
jaundice and closely monitored after hospital discharge to avoid the rare but
life-long consequences when this common condition becomes severe, the Canadian
Paediatric Society says.
    A CPS statement, Guidelines for detection, management and prevention of
hyperbilirubinemia in term and late preterm newborn infants (35 or more weeks'
gestation), published in this month's issue of the CPS peer-reviewed journal
Paediatrics & Child Health, offers new Canadian guidelines on recognizing and
treating hyperbilirubinemia.
    "Jaundice does not peak until newborns are three to five days old, at
which time the majority of them have already been discharged from hospital,"
said Dr. Keith Barrington, principal author of the statement and chair of the
CPS Fetus and Newborn Committee.
    "Jaundice can be hard to detect - especially at the time babies go home
from hospital. But the severity of jaundice can be predicted through
screening, which is now being recommended for all newborns in Canada," said
Dr. Barrington, a neonatologist at the Royal Victoria Hospital in Montreal.
    In rare cases, hyperbilirubinemia (an increase in the blood level of
bilirubin, which is the yellow substance causing jaundice) can lead to
kernicterus, a life-threatening condition affecting the brain and causing
long-term neurological damage such as hearing loss. Jaundice is a common and
usually harmless condition that affects 60% of newborns. Some need treatment
to stop the jaundice getting too severe. Two per cent go on to develop more
severe jaundice, often due to ineffective monitoring. A very small number of
the most extremely jaundiced babies can develop kernicterus.
    To reduce the occurrence of hyperbilirubinemia, the statement recommends
that bilirubin concentrations be measured in all infants between 24 hours and
72 hours of life. If a mother and her new baby go home before 24 hours, they
need an early follow-up visit to a health professional or a home visit by
someone who can administer a bilirubin test, as well as look after any other
potential health problems.
    The CPS also recommends that at the time of hospital discharge, a copy of
the health record including the bilirubin result is given to the family and
follow-up arrangements are made for those infants identified by the screening
as having a higher chance of becoming severely jaundiced so that they can be
examined and have a repeat test if needed.

    CPS recommendations:
    
    - Universal screening for jaundice among newborns should be implemented
      in Canada.
    - Adequate follow-up should be ensured for all infants who are jaundiced.
    - A program for breastfeeding support should be instituted in every
      facility where babies are delivered.
    

    The Canadian Paediatric Society is a national advocacy association that
promotes the health needs of children and youth. Founded in 1922, the CPS
represents more than 2,500 paediatricians, paediatric subspecialists and other
child health professionals across Canada.

    To access the full statement, visit:
    http://www.cps.ca/english/statements/FN/fn07-02.htm




For further information:

For further information: Media inquiries: Olivia Craft, Canadian
Paediatric Society, (613)526-9397, ext. 234, (613) 850-4868 (cell)

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CANADIAN PAEDIATRIC SOCIETY

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