Prolonged jaundice

David M Hall, retired,
November 01, 2010

Rodie et al comment on the NICE guidelines for prolonged jaundice in the newborn. Our study in Sheffield (Crofts DJ et al, Acta Paed. 1999; 88: 969-74) highlighted the dilemma created by guidelines devised by specialists for use in the community by primary care staff. Having been alerted to be more than ordinarily vigilant for prolonged jaundice, some staff had difficulty in deciding whether jaundice was present or not. A considerable amount of anxiety was caused by the referral and investigation of apparently well babies. The approach proposed by NICE does not meet the strict criteria for screening tests and perhaps there will never be a definitive answer as to the best policy for identifying serious disorders causing prolonged jaundice. However, our results confirmed that whereas prolonged jaundice is indeed common in breast fed babies, it is rare for it to persist beyond 28 days in formula fed infants. In breast fed babies who are well and have normal stool and urine colour, the yield of investigation is extremely small; but perhaps it is justifiable to be more proactive in formula fed babies with prolonged jaundice.

Conflict of Interest:

None declared

Conflict of Interest

None declared