Anemia of Prematurity - Portal Neonatal

Consultations:
Diet:
• Consider consultation with a neonatologist when the serum bilirubin level rises above 20
mg/dL (430 pmol/L) or when signs and symptoms suggest pathological jaundice and the rate
of rise in the serum bilirubin level is more than 0.5 mg/dL/h.
• Consultation with a lactation consultant is recommended in any breastfed baby who has
jaundice. The expertise can be extremely helpful, especially in situations in which inadequate
breastfeeding is contributing to the jaundice.
• Continue breastfeeding, if possible, and increase frequency of feeding to 8-12 times per day.
• Depending on maternal preference, breastfeeding can be supplemented or replaced by
formula at the same frequency. Supplementation with dextrose solution is not recommended
because it may decrease caloric intake and milk production and consequently delay the drop
in serum bilirubin concentration. Breastfeeding can also be supplemented by pumped breast
milk.
Activity:
• No restrictions are necessary.
• Encourage parents to remove the child from the warmer or infant crib for feeding and bonding.
Fiberoptic blankets allow holding and breastfeeding without interruption in treatment.
FOLLOW-UP Section 7 of 9
Further Inpatient Care:
• If the patient has not been discharged with the parent, monitoring daily weights and serum
bilirubin concentration for the need for phototherapy as well as assessment of caloric intake
are important. Once serum bilirubin concentration is determined to be within a safe range (