Objectives To study the changing need for exchanging transfusion in NNHB and to compare its frequency during the years 1997 and 2007.

Method A retrospective study of the charts of all cases of NNHB that were admitted to SCBU in our hospital in 1997 and in 2007 and to study the different causes of jaundice and the number of cases that needed exchange transfusion in each year.

Results Total number of deliveries in 1997: 9622. Total number of deliveries in 2007: 5725. Total number of 368 cases of NNHB were admitted in 1997 and 267 cases in 2007.

Exchange transfusions were performed in 67 cases (18%) in 1997 compared to 11 cases (4.2%) in 2007. ABO incompatibility was responsible for 38 cases (56%) in 1997 compared to 9 out of 11 cases (82%) in 2007.

Conclusion In the treatment of severe NNHB, exchange transfusion is now performed much less frequently than in the previous decade, about four times less. This was related to the increasing awareness of the public, the early referal of cases by the general practicioners and the pediatricians as well as the changed guidelines at which exchange transfusion is done at higher bilirubin levels.

ABO incompatibility is the main indication for exchange transfusion.