Pediatricians’ knowledge and perception of the care of the infant with jaundice

Abstract

Aim: Neonatal jaundice is a common cause for emergency department referral in the first weeks of life. Indirect bilirubin in high levels can cross the blood-brain barrier and cause bilirubin-induced neurotoxicity. This study aimed to evaluate primary care pediatricians’ self-perception, attitudes, and competency regarding the care of the jaundiced neonate. We evaluated the pediatricians’ knowledge of and adherence to the guidelines of the American Academy of Pediatrics and of the National Institute for Health and Care Excellence.

Methods: Structured questionnaires were distributed online by electronic mailing lists to community pediatricians.

Results: Overall, 188 physicians responded. Responses varied widely regarding the interpretation of cutaneous bilirubin levels. Adding milk formula to breastfeeding was recommended by 47 (25.0%) respondents. Twenty-six (13.8%) recommended temporary breastfeeding cessation to decrease bilirubin levels.

Conclusion: A considerable proportion of community pediatricians who responded to our survey described care for jaundiced neonates that deviates from current guidelines. Education should address the misconception that ceasing breastfeeding effectively lowers bilirubin levels.