Ann writes about her frustration with the jaundice protocol at her
hospital which, from the detail she's provided, sounds ridiculous and not at all in
line with the AAP's guidelines.   Routine phototx for bilirubins of 8 and
routine supplementation    for only slightly elevated levels are not supported by
any literature. After reviewing the AAP papers I find no support for the
routine, frequent testing (many times a day?) that Ann reports. My current
hospital only tests levels on babies who appear significantly jaundiced or are "set
ups", (ABO incompatibility etc). I haven't noticed much,if any change in
practice since the sentinel event proclamation.   Common sense dictates that there
are more reasonable practitioners in your hospital (pedis etc) who also find
the current practice to be overkill and not evidence based. Your concerns about
the negative effects on breastfeeding need to be heard and addressed with the
support of these fellow HCPs.
Good Luck!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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