Dear Editor, I have read with a keen interest the article by Balaguer et al (1) which documented clear benefits in the use of a software tool in the management of babies with neonatal jaundice, based on the latest American Academy of Pediatrics (AAP) Guidelines from 2004 (2).
We have recently designed and piloted a similar software tool for the screening and first-line investigation of babies presenting with prolonged neonatal jaundice. This software is based on a recent appraisal of current medical literature and available scientific evidence on the management of babies with prolonged jaundice. It is being used in conjunction with a local guideline based on the available evidence of best practice and literature review.
The highlights of the software include a clinical assessment of babies with prolonged jaundice including feeding history (breast or bottle), weight, documentation of stool and urine colour, history of appropriate doses of vitamin K administration at birth and neonatal heel-prick screening test, mother’s blood group, checking the babies for significant pallor and hepatosplenomegaly. Appropriate investigations are recommended based on the relevant positive clinical findings. For example babies from Mediterranean, Asian or Afro-Caribbean origin are investigated for G6PD status, clinically pale babies are screened for haemolysis and babies with hepatosplenomegaly are screened for common liver diseases (see attached figures).
The software has the optional features of automatically generating a letter to inform the parents and general practitioners of the patient about the findings of the screening tests and any indications for further follow-up.