Neonatal jaundice is common, but severe unconjugated hyperbilirubinemia can cause kernicterus and permanent neurological damage. Nurses are essential for early recognition and safe management.
Assessment
Assess jaundice in natural light, beginning at the face and progressing to the chest, abdomen, and legs. Check gestational age, age in hours, feeding pattern, urine and stool color, lethargy, poor sucking, temperature instability, and risk factors such as hemolysis or prematurity.
Nursing Interventions
- Ensure timely bilirubin testing when jaundice appears or risk factors are present.
- Start prescribed phototherapy promptly and use correct distance, shielding, and eye protection.
- Monitor temperature, hydration, weight, skin integrity, and bilirubin levels.
- Support frequent breastfeeding or expressed breast milk feeding.
- Recognize danger signs: extreme sleepiness, poor feeding, high-pitched cry, fever, or worsening jaundice.
Low-Resource Adaptations
Where transcutaneous bilirubin meters or laboratory tests are limited, use standardized clinical tools and maintain clear referral criteria. Do not delay transfer when hemolysis, severe jaundice, or signs of acute bilirubin encephalopathy are suspected.
Early assessment, effective feeding, and prompt phototherapy can prevent serious complications.