Primary Care Pediatricians’ Knowledge and Perception of the Care of the Infant with Hyperbilirubinemia

Introduction: Neonatal jaundice is almost universal in its occurrence. Despite awareness, screening, and effective treatment, it’s one of the leading causes for emergency department referral, morbidity and mortality. Primary care pediatricians represent the backbone of the pediatric health care system. The pediatrician`s goal is to investigate and refer select neonates who need further attention. This study aimed to evaluate the knowledge and perception of the primary care pediatrician regarding the care for the jaundiced neonate.

Methods: Structured questionnaires were distributed by electronic mailing list to community pediatricians working in the Clalit healthcare services.

Results: 182 physicians responded. Only 12% correctly recognized the risk factors for severe hyperbilirubinemia. Prolonged jaundice was defined as two weeks by 45.1% and there was wide variability regarding the interpretation of cutaneous bilirubin levels. Adding milk formula was recommended by 25.3% and 13.7% recommended temporary breastfeeding cessation. 76.9% of the physicians believed there should be a written protocol for neonatal jaundice, but only 17.6% had a written protocol in their clinic.

Conclusion: Pediatricians need to be familiar with the guidelines to provide the best care to jaundiced neonates. We should consider revising the statement paper to include topics not previously addressed and allow for standardized care.