The Management of Hyperbilirubinemia

When pre-established "safe" limits of serum bilirubin are exceeded, or when hyperbilirubinemia is present in association with other conditions such as prematurity with respiratory distress, asphyxia, or neonatal infections, the need to lessen the risk of bilirubin encephalopathy requires specific and effective interventions to lower the unconjugated or indirect-reacting bilirubin level in infants at risk. To this end the authors examine the criteria for intervention, the means of decreasing serum bilirubin levels, phototherapy, exchange transfusion, and the problem of jaundice in breast-fed infants.