{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:02:46Z","timestamp":1785776566345,"version":"3.56.0"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,1,1]]},"abstract":"<jats:p>Objective.\u2003To determine practice patterns of office-based pediatricians and neonatologists in the treatment of neonatal hyperbilirubinemia in healthy, term newborns during 1992, before the publication of the practice guideline for treatment of neonatal jaundice by the American Academy of Pediatrics (AAP).1 The survey was undertaken to inform the AAP's Subcommittee on Hyperbilirubinemia on current practices and to aid it in its preparation of the guidelines. It was also anticipated that this survey would serve as a basis for comparison for a second survey to be performed several years after the publication of the practice guidelines.<\/jats:p><jats:p>Methods.\u2003A self-administered questionnaire describing a single case of a jaundiced, breastfed 36-hour-old healthy, full-term infant with a total serum bilirubin concentration of 11.0 mg\/dL (188 \u03bcM\/L) was sent to a random sample of 600 office-based pediatricians and 606 neonatologists who were members of the AAP. The final response rate was 74%. Respondents were asked to answer questions regarding treatment of the case based on their actual practices. Ranges of total serum bilirubin concentration were provided as possible answers to questions on initiation of phototherapy and exchange transfusion, and interruption of breastfeeding. Respondents were also queried about frequency of serum bilirubin testing, locations of phototherapy administration, and factors influencing their therapeutic decisions.<\/jats:p><jats:p>Results.\u2003Four hundred forty-two office-based pediatricians and 444 neonatologists completed the survey. There was a tendency for neonatologists to initiate both phototherapy and exchange transfusions at lower serum bilirubin concentrations than office-based general pediatricians. At a serum bilirubin of 13 to 19 mg\/dL (222 to 325 \u03bcM\/L), 54% of office-based pediatricians stated they would initiate phototherapy whereas 76% of neonatologists would do so. Forty percent of office-based practitioners said they would perform exchange transfusions at serum bilirubin levels of 20 to 25 mg\/dL (342 to 428 \u03bcM\/L), whereas 60% of neonatologists said they would. Only a small percentage of both office-based practitioners (13%) and neonatologists (16%) indicated they would interrupt breastfeeding at 8 to 13 mg\/dL (137 to 222 \u03bcM\/L); but with each incremental level of serum bilirubin, an increasing proportion of neonatologists would interrupt breastfeeding. Little correlation was found between treatment practices and demographic characteristics except for years in practice; physicians with the fewest years in practice (5 years or less) differed significantly from all other groups of physicians in initiating exchange transfusions at higher serum bilirubin concentrations.<\/jats:p><jats:p>Conclusions.\u2003The results of this survey indicated a wide range of variation of opinion among both groups of physicians, most likely a reflection of the uncertainty and controversy surrounding these issues. The data may also reflect a possible wide range of \u201cacceptable practice\u201d as opposed to a narrow treatment standard. Office-based practitioners more closely approximated the new 1994 recommendations than neonatologists.1<\/jats:p>","DOI":"10.1542\/peds.101.1.25","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"25-31","source":"Crossref","is-referenced-by-count":31,"title":["Practice Patterns in Neonatal Hyperbilirubinemia"],"prefix":"10.1542","volume":"101","author":[{"given":"Lawrence M.","family":"Gartner","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics and Obstetrics & Gynecology, the University of Chicago, Chicago, Illinois; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla T.","family":"Herrarias","sequence":"additional","affiliation":[{"name":"Division of Quality Care, American Academy of Pediatrics, Elk Grove Village, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Sebring","sequence":"additional","affiliation":[{"name":"Division of Quality Care, American Academy of Pediatrics, Elk Grove Village, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,1,1]]},"reference":[{"key":"2021120904461361100_B1","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1542\/peds.94.4.558","article-title":"Practice parameter: management of hyperbilirubinemia in the healthy term newborn.","volume":"94","author":"American Academy of Pediatrics, Provisional Committee for Quality Improvement and Subcommittee on Hyperbilirubinemia","year":"1994","journal-title":"Pediatrics"},{"key":"2021120904461361100_B2","first-page":"109","article-title":"Zur kenntnis des ikterus neonatorum, Insbesondere der dabei auftretenden gehirnveranderunger.","volume":"15","author":"Schmorl","year":"1904","journal-title":"Verh Dtsch Ges 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hyperbilirubinemia.","volume":"75(suppl)","author":"Brown","year":"1985","journal-title":"Pediatrics"},{"key":"2021120904461361100_B7","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0065-3101(24)00161-0","article-title":"Breast milk and breastfeeding jaundice.","volume":"34","author":"Gartner","year":"1987","journal-title":"Adv Pediatr"},{"key":"2021120904461361100_B8","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1542\/peds.91.2.470","article-title":"Hyperbilirubinemia in the breast-fed newborn: a controlled trial of four interventions.","volume":"91","author":"Martinez","year":"1993","journal-title":"Pediatrics"},{"key":"2021120904461361100_B9"},{"key":"2021120904461361100_B10"},{"key":"2021120904461361100_B11","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0140-6736(82)90440-8","article-title":"Use or abuse of phototherapy for physiological jaundice of newborn infants.","volume":"2","author":"Lewis","year":"1982","journal-title":"Lancet"},{"key":"2021120904461361100_B12"},{"key":"2021120904461361100_B13","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1542\/peds.89.5.827","article-title":"Jaundice in healthy term neonates: do we need new action levels or new approaches?","volume":"89","author":"Brown","year":"1992","journal-title":"Pediatrics"},{"key":"2021120904461361100_B14"},{"key":"2021120904461361100_B15","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1542\/peds.96.4.730","article-title":"Kernicterus in otherwise healthy, breast-fed newborns.","volume":"96","author":"Maisels","year":"1995","journal-title":"Pediatrics"},{"key":"2021120904461361100_B16","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S0022-3476(95)70177-X","article-title":"Role of hemolysis in neonatal jaundice associated with glucose-6-phosphate dehydrogenase deficiency.","volume":"127","author":"Seidman","year":"1995","journal-title":"J Pediatr"},{"key":"2021120904461361100_B17","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1136\/adc.68.5_Spec_No.529","article-title":"Neonatal jaundice\u2014a lighter touch.","volume":"16","author":"Dodd","year":"1993","journal-title":"Arch Dis Child"},{"key":"2021120904461361100_B18","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1542\/pir.15-11-422","article-title":"Neonatal jaundice.","volume":"15","author":"Gartner","year":"1994","journal-title":"Pediatr 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