Adherence to phototherapy guidelines in term neonates: Study at a private tertiary-level neonatal unit

Abstract

Guidelines for starting phototherapy for neonatal jaundice in term neonates have been published by the American Academy of Pediatrics (AAP) and others, such as the National Institute for Health and Clinical Excellence (NICE), but the practical implementation of such guidelines and factors associated with possible non-adherence have not been studied. We report our experience at a self-paying tertiary-care hospital. Of the 155 term babies given phototherapy in our hospital between August 2012 and August 2013, 65 (41.9%) babies were found to have received phototherapy at serum bilirubin values lower than recommended AAP guidelines. Factors found responsible for non-adherence to guidelines were: (i) parents’ request for early discharge, with unwillingness to come the next day for follow-up despite borderline serum bilirubin level noted in 25 (38.5%); (ii) clinical assessment of bilirubin was higher than reported laboratory value in 16 (24.6%); and (iii) babies were given phototherapy as parents had been counselled regarding the need for phototherapy by a referring paediatrician in 12 (18.5%).