I posted earlier today on a baby with bili level 17 this a.m. admitted to
hosp for double lites. B.wt 7#0, hosp discharge wt 6#7, today 6#15 so had
gained 8 oz. No blood incompatibility, Coombs neg, no bruising. He was now
feeding and pooping since we fixed engorgement. His 12 noon level came down
to 14 and he was discharged home on phototherapy blanket for overnite.
Surely this child did not need to be admitted. [I will concede that the
lites did help the bili levels come down rapidly.]

I see in L. Gartner, MD, Neonatal Jaundice, Pediatrics in Review, 15(11),
1994 the guidelines and I read some letters to editor in response stating
that even this practice guideline was overly interventionist. Has anything
been revised since then or is this article basically the standard most USA
pedis would use? Anyone have anything even more authoritative that would
save some of these babies too much intervention.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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