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Date: | Sat, 20 Nov 1999 19:05:02 +0000 |
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We measure jaundice differently, so I have no idea what the levels given in
Judy's post are equal to. I do know that forward-thinking and bf-friendly
paediatricians believe pathologcal jaundice is gravely overdiagnosed and
treated here.
There are several studies showing the huge variation in what would be
considered to be a normal level of jaundice in the first two weeks of life.
Dr Edmund Hey's essay in MIDIRS, March 1995, deals with some of these
issues, with a useful overview of diagnosis and treatment. He recommends
an icterometer (mentioned on this list a week or so ago!) which is a
pocket-held colour-matching tool costing 20 US dollars; staff learning to
train their eyes; and lab blood sample ordered when there is a reading of
3.5 on the icterometer.
He points out that lab results are very variable, too.
There are lots of refs in this article. His article is also based on a
lifelong interest in this topic. I have heard him speak twice on this
issue, and he is very, very irritated with his colleagues for their lack of
evidence-based practice.
His conclusion is that when there is no haemolytic disease present,
jaundice calls for medical treatment 'in one term baby in a 1000'.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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