Universal screening for neonatal hyperbilirubinemia with transcutaneous bilirubinometer (TcB) is recommended at the time of discharge from the health center.
Physicians should ensure that all newborns are systematically monitored to rule out the potential occurrence of jaundice during the stay in the health center.
The postnatal age for universal TcB screening at discharge should be based on when the baby is discharged from the health center.
The WHO Guidelines Development Group (GDG) considered that all healthy newborns should receive care in the health center for at least 24 hours after birth.
The GDG considered that transcutaneous bilirubin screening at discharge should be followed by the assessment of serum bilirubin, appropriate therapy, and follow-up as indicated by age-appropriate nomograms. (Nomogram: chart providing age-specific hour-based TcB and total serum bilirrubin or TSB values. It helps determine when to test serum bilirubin and to decide on the need for phototherapy or exchange transfusion depending on the child’s postnatal age and clinical risk factors).
When comparing universal TSB determination with universal screening by TcB, there is not enough evidence to make a recommendation for or against universal TSB screening at the time of discharge from the facilities, so no recommendation is made regarding TSB screening. According to the GDG, costs are high, and feasibility and acceptability differ markedly.
The GDG emphasized the validity of the current WHO recommendations on routine screening of newborns looking for signs of danger, including jaundice in the first 24 hours postnatally and the observation of yellow palms and soles at any age. These conditions indicate the need to take a TSB determination to define whether therapy is needed or not.
