Abstract
When a decision is made to treat HBI in a breast fed infant, there are a number of options available but they have never been compared. We enrolled fullterm, healthy breast feed newborn infants when their serum bilirubin(BI)levels reached 17mg/dl and assigned them ramdomly to one of four interventions. 1)Discontinue breast feeding(DBF), 2)phototherapy and DBF, 3)photoptherapy, continue BF, 4)observe. There were no differences between the groups in the sex ratio, delivery mode, birth weight or gestation. Mean serum Bl levels declined in all groups by 48 hours but in the first 24 hours the decline was significantly greater in groups 2 and 3 (p<.05 versus group 4).
Although intervention 2 was most effective, serum BI did not reach 20mg/dl in 76% of infants in group 4. Even if“vigintiphobia”determines our actions, any of these interventions is an acceptable initial approach to the fullterm breast fed infant with significant HBI. These data can be presented to parents who can then make an informed decision regarding which intervention they prefer.
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Martinez, J., Maisels, M., Otheguy, L. et al. MANAGEMENT OF SEVERE HYPERBILIRUBINEMIA (HBI) IN FULLTERM NEWBORNS. A CONTROLLED TRIAL OF 4 INTERVENTION.. Pediatr Res 33, 662 (1993). https://doi.org/10.1203/00006450-199306000-00042
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DOI: https://doi.org/10.1203/00006450-199306000-00042