Management of hyperbilirubinemia in near ... term newborns according to American Academy of Pediatrics Guidelines: Report of three cases

All neonates have a transient rise in bilirubin levels, and about 30-50% of infants become visibly jaundiced.1,2 Most jaundice is benign; however, because of the potential brain toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. Ten percent of term infants and 25% of near-term infants have significant hyperbilirubinemia and require phototherapy. 3 The American Academy of Pediatrics (AAP) recommends procedures to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy, and to minimize the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment.4 The guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 weeks or more of gestational age (term and near-term newborns). This case report details the management of three newborns of 35 or more gestational age at the Siloam Lippo Cikarang Hospital, Tanggerang, West Java, Indonesia according to the AAP guidelines