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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="National Collaborating Centre for Women's and Children's Health (UK)" /><meta name="citation_title" content="Neonatal Jaundice" /><meta name="citation_publisher" content="RCOG Press" /><meta name="citation_date" content="2010/05" /><meta name="citation_author" content="National Collaborating Centre for Women's and Children's Health (UK)" /><meta name="citation_pmid" content="22132434" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK65119/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Neonatal Jaundice" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="RCOG Press" /><meta name="DC.Contributor" content="National Collaborating Centre for Women's and Children's Health (UK)" /><meta name="DC.Date" content="2010/05" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK65119/" /><meta name="description" content="Jaundice is one of the most common conditions requiring medical attention in newborn babies. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breastfed babies are still jaundiced at 1 month of age. In most babies with jaundice thevre is no underlying disease, and this early jaundice (termed ‘physiological jaundice’) is generally harmless. However, there are pathological causes of jaundice in the newborn, which, although rare, need to be detected. Such pathological jaundice may co-exist with physiological jaundice." /><meta name="og:title" content="Neonatal Jaundice" /><meta name="og:type" content="book" /><meta name="og:description" content="Jaundice is one of the most common conditions requiring medical attention in newborn babies. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breastfed babies are still jaundiced at 1 month of age. In most babies with jaundice thevre is no underlying disease, and this early jaundice (termed ‘physiological jaundice’) is generally harmless. However, there are pathological causes of jaundice in the newborn, which, although rare, need to be detected. Such pathological jaundice may co-exist with physiological jaundice." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK65119/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg98-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="warning" content="Update information Since original publication this guideline has been partially updated by NICE: In October 2016, recommendation 1.4.9 was amended to clarify when intensified phototherapy should be used in relation to time since birth." /><meta name="bk-non-canon-loc" content="/books/n/nicecg98/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK65119/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/nicecg98guid/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg98guid-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/nicecg98guid/">See 2016 Partial Update</a></span></li></ul></div></div></div><div class="messagearea bk_noprnt" style="margin-bottom:1.3846em "><ul class="messages"><li class="warn icon"><span class="icon">Update information Since original publication this guideline has been partially updated by NICE: In October 2016, recommendation 1.4.9 was amended to clarify when intensified phototherapy should be used in relation to time since birth.</span></li></ul></div><div class="bk_prnt"><p style="color:red;"><strong>Update information Since original publication this guideline has been partially updated by NICE: In October 2016, recommendation 1.4.9 was amended to clarify when intensified phototherapy should be used in relation to time since birth.</strong></p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="https://www.rcog.org.uk/" title="RCOG Press" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg98-lrg.png" alt="Cover of Neonatal Jaundice" /></a><div class="icnblk_cntnt"><h1 id="_NBK65119_"><span itemprop="name">Neonatal Jaundice</span></h1><p><i>NICE Clinical Guidelines, No. 98</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Collaborating Centre for Women's and Children's Health (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.rcog.org.uk/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">RCOG Press</span></a>; <span itemprop="datePublished">2010 May</span>.</div><div><a href="/books/about/copyright/">Copyright</a> © 2010, Royal College of Obstetricians and Gynaecologists.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Excerpt</h2><p>Jaundice is one of the most common conditions requiring medical attention in newborn babies. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breastfed babies are still jaundiced at 1 month of age. In most babies with jaundice thevre is no underlying disease, and this early jaundice (termed ‘physiological jaundice’) is generally harmless. However, there are pathological causes of jaundice in the newborn, which, although rare, need to be detected. Such pathological jaundice may co-exist with physiological jaundice.</p><p>Neonatal jaundice refers to yellow colouration of the skin and the sclera (whites of the eyes) of newborn babies that results from accumulation of bilirubin in the skin and mucous membranes. This is associated with a raised level of bilirubin in the circulation, a condition known as hyperbilirubinaemia.</p></div><div><h2>Contents</h2><ul id="toc_tllNBK65119_toc_nicecg98_fm_s1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK65119_toc_nicecg98_fm_s1"><a class="toc-item" href="/books/n/nicecg98/nicecg98.fm.s1/">Guideline Development Group and acknowledgements</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1"><a class="toc-item" href="/books/n/nicecg98/ch1/">1. Guidance summary</a><ul id="toc_lst_NBK65119_toc_ch1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s1"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s1">1.1. Key terms</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s2"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s2">1.2. Key priorities for implementation</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s10"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s10">1.3. Threshold table</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s11"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s11">1.4. Summary of all recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s12"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s12">1.5. Research recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s34"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s34">1.6. Treatment threshold graphs</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch1_s35"><a class="toc-item" href="/books/n/nicecg98/ch1/#ch1.s35">1.7. Investigation, phototherapy and exchange transfusion pathways</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2"><a class="toc-item" href="/books/n/nicecg98/ch2/">2. Introduction</a><ul id="toc_lst_NBK65119_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s1"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s1">2.1. Neonatal jaundice</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s8"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s8">2.2. Aim of the guideline</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s9"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s9">2.3. Areas outside the remit of the guideline</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s10"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s10">2.4. Who has developed the guideline</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s11"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s11">2.5. Related NICE guidance</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch2_s12"><a class="toc-item" href="/books/n/nicecg98/ch2/#ch2.s12">2.6. Guideline methodology</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch3"><a class="toc-item" href="/books/n/nicecg98/ch3/">3. Factors that influence hyperbilirubinaemia and kernicterus</a><ul id="toc_lst_NBK65119_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch3_s1"><a class="toc-item" href="/books/n/nicecg98/ch3/#ch3.s1">Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch3_s2"><a class="toc-item" href="/books/n/nicecg98/ch3/#ch3.s2">3.1. Factors that influence hyperbilirubinaemia</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch3_s7"><a class="toc-item" href="/books/n/nicecg98/ch3/#ch3.s7">3.2. Risk factors for kernicterus and/or adverse sequelae</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch4"><a class="toc-item" href="/books/n/nicecg98/ch4/">4. Early prediction of serious hyperbilirubinaemia</a><ul id="toc_lst_NBK65119_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch4_s1"><a class="toc-item" href="/books/n/nicecg98/ch4/#ch4.s1">Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch4_s2"><a class="toc-item" href="/books/n/nicecg98/ch4/#ch4.s2">4.1. Tests that predict hyperbilirubinaemia</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch4_s26"><a class="toc-item" href="/books/n/nicecg98/ch4/#ch4.s26">4.2. Tests that do not predict hyperbilirubinaemia</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch5"><a class="toc-item" href="/books/n/nicecg98/ch5/">5. Recognition</a><ul id="toc_lst_NBK65119_toc_ch5" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch5_s1"><a class="toc-item" href="/books/n/nicecg98/ch5/#ch5.s1">Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch5_s2"><a class="toc-item" href="/books/n/nicecg98/ch5/#ch5.s2">5.1. Visual/clinical examination</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch5_s14"><a class="toc-item" href="/books/n/nicecg98/ch5/#ch5.s14">5.2. Devices for measuring bilirubin</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch6"><a class="toc-item" href="/books/n/nicecg98/ch6/">6. Formal assessment for the causes of neonatal hyperbilirubinaemia</a><ul id="toc_lst_NBK65119_toc_ch6" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch6_s1"><a class="toc-item" href="/books/n/nicecg98/ch6/#ch6.s1">Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch6_s4"><a class="toc-item" href="/books/n/nicecg98/ch6/#ch6.s4">6.1. Tests to detect underlying disease in all babies with hyperbilirubinaemia</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch6_s30"><a class="toc-item" href="/books/n/nicecg98/ch6/#ch6.s30">6.2. Formal assessment of babies with prolonged jaundice</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7"><a class="toc-item" href="/books/n/nicecg98/ch7/">7. Treatment</a><ul id="toc_lst_NBK65119_toc_ch7" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7_s1"><a class="toc-item" href="/books/n/nicecg98/ch7/#ch7.s1">7.1. How to manage hyperbilirubinaemia</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7_s17"><a class="toc-item" href="/books/n/nicecg98/ch7/#ch7.s17">7.2. Phototherapy</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7_s103"><a class="toc-item" href="/books/n/nicecg98/ch7/#ch7.s103">7.3. Exchange transfusion</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7_s115"><a class="toc-item" href="/books/n/nicecg98/ch7/#ch7.s115">7.4. Other treatments</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch7_s154"><a class="toc-item" href="/books/n/nicecg98/ch7/#ch7.s154">7.5. Satisfaction with treatment</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch8"><a class="toc-item" href="/books/n/nicecg98/ch8/">8. Information</a><ul id="toc_lst_NBK65119_toc_ch8" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65119_toc_ch8_s1"><a class="toc-item" href="/books/n/nicecg98/ch8/#ch8.s1">Description of included studies</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app1"><a class="toc-item" href="/books/n/nicecg98/appendixes.app1/">Appendix A. Scope</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app2"><a class="toc-item" href="/books/n/nicecg98/appendixes.app2/">Appendix B. Declarations of interest</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app3"><a class="toc-item" href="/books/n/nicecg98/appendixes.app3/">Appendix C. Economic evaluation of alternative testing strategies in the detection of hyperbilirubinaemia</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app4"><a class="toc-item" href="/books/n/nicecg98/appendixes.app4/">Appendix D. Cost-effectiveness of intravenous immunoglobulin (IVIG)</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app5"><a class="toc-item" href="/books/n/nicecg98/appendixes.app5/">Appendix E. Implementation tools</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app6"><a class="toc-item" href="/books/n/nicecg98/appendixes.app6/">Appendix F. Registered stakeholder organisations</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app7"><a class="toc-item" href="/books/n/nicecg98/appendixes.app7/">Appendix G. Clinical questions</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app8"><a class="toc-item" href="/books/n/nicecg98/appendixes.app8/">Appendix H. Evidence tables</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app9"><a class="toc-item" href="/books/n/nicecg98/appendixes.app9/">Appendix I. Search strategies</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_appendixes_app10"><a class="toc-item" href="/books/n/nicecg98/appendixes.app10/">Appendix J. Excluded studies</a></li><li class="half_rhythm" id="toc_itm_NBK65119_toc_abbreviations_s1"><a class="toc-item" href="/books/n/nicecg98/abbreviations.s1/">Abbreviations, Glossary and References</a></li></ul></div><div><p>While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.</p><p>This guideline has been fully funded by NICE. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient.</p><p>Implementation of this guidance is the responsibility of local commissioners and/or providers.</p></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2010, Royal College of Obstetricians and Gynaecologists.<p class="small">No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.</p><p class="small">The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.</p></div><div class="small"><span class="label">Bookshelf ID: NBK65119</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/22132434" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">22132434</a></span></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg98/nicecg98.fm.s1/" title="Next page in this title">Next ></a></div></div></div></div>
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