DIRECTOR GENERAL OF HEALTH MALAYSIA
LAUNCHING OF THE
CLINICAL PRACTICE GUIDELINES ON
MANAGEMENT OF NEONATAL JAUNDICE (SECOND EDITION)
Jaundice is one of the most common conditions needing medical attention in newborn babies and is due to high levels of bilirubin in the blood. Worldwide, about 60% of term babies and 80% of preterm babies develop jaundice in the first week of life. In most babies, early jaundice is physiological and harmless. However, some babies may develop severe jaundice, which can be harmful if left untreated. High levels of bilirubin can lead to brain damage, which may result in neurodevelopmental impairment (such as cerebral palsy, visual and hearing loss). Hence, early detection of neonatal jaundice (NNJ) is very important, followed by timely referral and appropriate treatment.
Phototherapy remains the mainstay of treatment for neonatal jaundice. It is safe and effective. The newer phototherapy units offer more effective treatment with fewer babies with jaundice who require exchange transfusions. Despite this, there are still parents who unnecessarily expose their jaundiced babies to sunlight. This traditional practice is no longer advocated as it is not an effective treatment for NNJ and it exposes the baby to harmful effects. There is also no evidence to support other traditional practices such as feeding jaundiced babies with goats’ milk and bathing the babies with yellow-coloured herbs. Parental education is of utmost important in dispelling the myths surrounding this common condition. Early detection and timely, effective treatment should be emphasised to prevent long-term adverse outcomes.
It is thus appropriate that the CPG on Management of Neonatal Jaundice be revised and updated. The previous edition focused mainly on the management of jaundice in term babies. With improving survival rate of preterm infants in our country, it is also important to address the management of jaundice in this group of patients. The new edition covers various aspects of NNJ management from screening to treatment. It has also highlighted certain important aspects such as the impact of breastfeeding on neonatal jaundice, parental education, effectiveness of pharmacotherapy and traditional medicine, and various preventive measures in the management of NNJ.
The Ministry of Health (MOH) is always supportive of any effort aimed at improving delivery of healthcare services. We will continue to ensure that babies with NNJ are given the best of care by equipping healthcare providers in MOH with relevant knowledge and skills to manage the condition (such as training using the CPG training module); and making available the necessary equipments for its detection and treatment.
DATUK DR. NOOR HISHAM BIN ABDULLAH
Director General of Health Malaysia
Ministry of Health Malaysia
26th October 2015