Background and aims Infants with severe hyperbilirubinaemia can develop kernicterus and have significant adverse outcomes.

A previous study in this hospital showed a significant number of infants presenting with an initial serum bilirubin (SBR) above exchange transfusion level.

Since that study the Bhutani Nomogram has been introduced. Our main aim was to see if the introduction of this Nomogram helped to reduce presentations with severe hyperbilirubinaemia.

Methods We looked at initial SBRs taken in infants ≥36 weeks gestation and ≥2.5 kgs birth weight born in 2012. We excluded infants of mothers with known antibodies as these infants may have had cord blood tested for direct Coombs status (DCT). We looked at infants whose DCT status was not known.

Results We compared our results to those obtained in the previous study from 2007/2008.

There has been a significant reduction in infants reaching exchange transfusion level with no infant above this level in 2012.

Conclusions The Bhutani Nomogram is an effective tool in helping to reduce cases of severe hyperbilirubinaemia.

The original study performed by Bhutani et al . to develop this Nomogram excluded DCT positive infants. This study shows that this Nomogram is effective in a population where the DCT status is not known.