Doctor reviews: How to manage HYPERBILIRUBINEMIA!

For PDF summaries of our videos and 50 extra multiple choice questions,

For anyone who takes care of newborns!! When do we get the baby's blood type? When to check a bilirubin? Is a transcutaneous bilirubin accurate? How do we figure out when to start phototherapy? What about IV fluids? Should we supplement feeds? When do we get a rebound bili? When do we perform an exchange transfusion??!!! So many questions!!
The AAP released an updated policy statement in 2022 on how to take care of babies with jaundice above 35 weeks. In this video we cover that paper- and all their Key Action Statements.
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Kemper AR, Newman TB, Slaughter JL, Maisels MJ, Watchko JF, Downs SM, Grout RW, Bundy DG, Stark AR, Bogen DL, Holmes AV, Feldman-Winter LB, Bhutani VK, Brown SR, Maradiaga Panayotti GM, Okechukwu K, Rappo PD, Russell TL. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022 Sep 1;150(3):e2022058859. doi: 10.1542/peds.2022-058859. PMID: 35927462.

Sarathy L, Chou JH, Romano-Clarke G, Darci KA, Lerou PH. Bilirubin Measurement and Phototherapy Use After the AAP 2022 Newborn Hyperbilirubinemia Guideline. Pediatrics. 2024 Apr 1;153(4):e2023063323. doi: 10.1542/peds.2023-063323. PMID: 38482582.

Csoma Z, Kemeny L, Olah J. Phototherapy for neonatal jaundice. N Engl J Med. 2008 Jun 5;358(23):2523-4; author reply 2524-5. PMID: 18536103.

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***TIMESTAMPS***
01:58 Prevention of hyperbilirubinemia
04:28 Assessment and Monitoring of hyperbilirubinemia
11:22 Treatment of hyperbilirubinemia
24:57 Post-Discharge follow up
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

[Fannylouisa]

I could listen to you all day! So interesting

[philipthankgod]

Although im a medical equipment sales person, i put on my notification so as not to miss any of your video. They are highly enlightening.

Thank you Dr.

[Learnbygiving]

Hi Talah,

New Intern here starting on the newborn unit- your video has sincerely improved my quality of life by giving a beautiful walk through of these clinical guidelines in a time efficient manner. Additionally its great to get confirmation from an attending that what I'm comprehending is in line with your interpretation.

[amalshehata]

Thanks for the precise, precious and clinically accurate Awad updated information

[lemmylungu]

Watching from Zambia. Very informative and looking forward to more such updates❤

[douyeevinson]

Thank you Dr tala!
Watching from Nigeria 🇳🇬

[malikkamuki]

Yes please do similar policy statements 👍👍👍

[basmadahash]

Very helpful! Watching from MI. Can you please talk about some other important AAP recommendations for different neonatal-related topics.

[NNCCCC]

Greetings from Timonium (the town, not the radiotracer). Yet another goldmine of information. thank you !

[colamember]

Dr. Tala. Thank you for all you do. Perfect video! Very helpful.

[ayasakr]

Great talk as usual, thank U so much Dr Tala, watching from Egypt ❤

[kennedyadjei-fosu]

Thank you so much Dr. Tala. Excellent delivery. Watching from Navrongo, Ghana

[beverlyreyes]

Another good bili tool source to use is the Stanford Bilirecs. It has 2 different tool, one for term and one for preterm .

[christoph]

How do you, in your practice, tell that a newborn has „Hemolysis“? It strikes me as a difficult question, since neither Hemoglobin, LDH nor Haptoglobin seem to be performing well in telling that a baby has hemolysis. When reading the literature, it seems to me that often times a baby with hyperbilirubinema that has a classic constellation of Blood Groups (Mom O, baby something else) and a positive direct Coombs test is simply consideres to having hemolysis. How do you do it? How do you diagnose the newborn with hemolysis?

[kebedealemu]

thnk you dr tala pediatric resident from Ethiopia, how can I access this material

[marinafrancis]

What cord Bili level would send a baby to the NICU immediately to start phototherapy?

[shabirdraayatmalla]

Thank you Dr.Tala for putting words into action….Excellent….Can you make me wiser about BILITOOL being used for starting PT or escalation of care….Thanks

[kaetiicat]

Could you do a video about use cbc interpretation when looking for signs of infection rather than crp’s? Our docs have been switching over to closer cbc detail rather than crps

[femiearnest]

Beautiful and quite illuminative. Well done Dr Tala. Can I get a link to this AAP recommendations? Could checking TCBs in unexposed parts of a baby (like the Anterior Iliac spine covered by diapers) when a baby is already on Phototherapy work? or TCBs are totally inaccurate when Phototherapy has begun. Enjoyed watching this from Nigeria. Good Job Doc!

[beverlyreyes]

We havent done exchange transfusion for over 15 years in our unit. The IVIG been a good help. Can u explain it more how it works for hyperbili? Mechanism?