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Jaundice in newborn babies under 28 days: NICE guideline 2016 (CG98)
  1. Rachel C Amos,
  2. Hannah Jacob,
  3. Wynne Leith
  1. Whittington Hospital, London, UK
  1. Correspondence to Dr Rachel C Amos, Whittington Hospital, Magdala Avenue, London N19 5NF, UK; amos.rachel{at}nhs.net

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Current guideline

In May 2016, the National Institute for Health and Care Excellence (NICE) published updated guidelines entitled ‘Jaundice in newborn babies under 28 days’ (box 1).1 The guideline covers diagnosis and treatment of neonates with jaundice, aiming ‘to help detect and prevent very high levels of bilirubin’. New recommendations focus on measuring and monitoring bilirubin levels and the type of phototherapy. Here, we summarise the guideline, highlighting updates and relevance to clinical practice.

Box 1

Resources

www.nice.org.uk/guidance/CG98

Link to NICE guideline and threshold table

www.nice.org.uk/guidance/cg98/resources

Link to treatment threshold graphs

www.nice.org.uk/Guidance/cg98/evidence

Link to guideline committee's discussion and evidence reviews

Previous guideline

The original NICE guideline CG98, published in May 2010, was jointly developed with the National Collaborating Centre for Women and Children's Health (now part of the National Guideline Alliance) to encourage more uniform, evidence-based practice.

Key messages

  • Care for all babies: use every opportunity in the first 72 hours to visually inspect babies for jaundice, particularly in the first 48 hours for those at higher risk (table 1). Examine in bright, natural light, pressing gently to look for jaundice on ‘blanched’ skin, and checking sclera and gums particularly in darker skinned babies. Do not measure bilirubin level routinely in babies who do not appear visibly jaundice, equally do not use visual inspection alone to estimate bilirubin level. Always keep parents/carers well informed (box 2).

    Box 2

    What do I need to do to inform the families in my care?

    In identifying jaundice

    • Listen to parents/carers …

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