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NeoReviews Vol.7 No.1 2006 e4
© 2006 American Academy of Pediatrics

Argentinean Perspective of the 2004 AAP Hyperbilirubinemia Guidelines

^* Chairman, Department of Pediatrics, del Salvador University School of Medicine B.A.; Chief, Neonatal Unit, Mother and Infant Hospital Ramón Sarda, Buenos Aires, Argentina

The first 20% of the full text of this article appears below.

	Introduction

 
The proper management of neonatal jaundice is the most frequent challenge faced daily by pediatricians. Kernicterus is not a frequent condition, but the uncertainty of which babies could develop it makes the problem of great concern. Advice from experts and published guidelines has attempted to guide us during the past few decades through the maze of "vigintophobia," "kinder and gentler approach," debates, discussions, risk factors, and nomograms. Care practices for the newborn and his or her mother have changed dramatically during recent years, with early discharge and breastfeeding promotion being the current practices that could have an important impact on the incidence, management during hospital stay, and follow-up of hyperbilirubinemia. Knowledge of genetic predisposition is an unknown factor that adds uncertainty but promises better definition of babies at risk in the future.

	The Guidelines

 
The new 2004 guidelines of the American Academy of Pediatrics (AAP) concerning management of hyperbilirubinemia in the newborn infant at 35 or more weeks’ gestation is a new and substantial effort to produce a thoughtful tool for pediatricians to use everywhere, not only in the United States. I would like to submit the perspective from Argentina and emphasize those points that undoubtedly will be of great help. One of the primary impacts of the guidelines has been the provision of a very good example of how to develop the procedures to generate useful guidelines. The evidence-based approach used to develop the guidelines and the explicit link between benefits and recommendations make them clear and explain their real significance. They represent an excellent model to be imitated each time we decide to develop new guidelines of any type.

	Breastfeeding

 
A paramount step in initiating the recommendations was to promote and support successful breastfeeding and explain clearly that jaundice associated with breastfeeding depends on inadequate breastfeeding rather . . . [Full Text of this Article]

This article has been cited by other articles:

				M. F. B. de Almeida and C. M. Draque Neonatal Jaundice and Breastfeeding NeoReviews, July 1, 2007; 8(7): e282 - e288. [Abstract] [Full Text] [PDF]