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All neonates have a transient rise in
bilirubin levels, and about 30-50% of
infants become visibly jaundiced.1,2
Most jaundice is benign; however,
because of the potential brain toxicity of bilirubin,
newborn infants must be monitored to identify
those who might develop severe hyperbilirubinemia
and, in rare cases, acute bilirubin encephalopathy
or kernicterus. Ten percent of term infants
and 25% of near-term infants have significant
hyperbilirubinemia and require phototherapy. 3
The American Academy of Pediatrics (AAP)
recommends procedures to reduce the incidence
of severe hyperbilirubinemia and bilirubin
encephalopathy, and to minimize the risks of
unintended harm such as maternal anxiety,
decreased breastfeeding, and unnecessary costs
The guidelines provide a framework for the
prevention and management of hyperbilirubinemia
in newborn infants of 35 weeks or more of
gestational age (term and near-term newborns).
This case report details the management of three
newborns of 35 or more gestational age at the
Siloam Lippo Cikarang Hospital, Tanggerang, West
Java, Indonesia according to the AAP guidelines.
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