Hyperbilirrubinemia

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 first days after birth, jaundice (yellow color of the skin and mucous membranes) is treated light therapy, also known as phototherapy. Wearing only a diaper, the baby is placed under a device that delivers blue light. This light is the specific therapy because it changes the chemical structure of bilirubin, rendering it easier to eliminate.
If a newborn requires phototherapy because of high blood bilirubin levels, it should be administered in a timely manner to prevent any injury to the central nervous system.

The yellowish color of the skin in newborns is called "jaundice". It may occur on the first days of life due to the accumulation of bilirubin, a pigment present in red blood cells.

The liver is the organ that sends bilirubin from the bloodstream to the gut, which in turn expels it from the body through the stools. The first days of life, the liver functions slowly; bilirubin is not cleared fast enough; it builds up in the blood, and enters all organs, including skin and brain. If bilirubin reaches very high levels in the brain, it can damage the neurons.

It is essential to ensure that all newborns are routinely monitored for the development of jaundice and that serum bilirubin should be measured in those at risk:
• in all babies if jaundice appears on day 1
• in preterm babies (<35 weeks) if jaundice appears on day 2
• in all babies if palms and soles are yellow at any age
Term and preterm newborns with hyperbilirubinaemia should be treated with phototherapy or exchange transfusion guided by the following cut-off levels of serum hyperbilirubinaemia shown in the table.