An osteopathic approach to reduction of readmissions for neonatal jaundice

Jaundice is a potentially life-threatening condition that continues to affect at-risk newborns, accounting for continued hospital readmissions. As family physicians, we should be cognizant of neonates who may be at risk for jaundice, including those with pathologic jaundice as well as newborns of breastfeeding mothers, and ensure sufficient intervention is taken to help prevent further elevations in bilirubin levels. Interventions are likely to include evaluation for sepsis, education regarding feeding frequencies for both breast- and bottle-fed neonates, reviewing maternal and hematologic risk factors for neonatal jaundice, and considering inborn errors of metabolism. An additional measure family physicians may consider is that of neonatal massage for those with elevated bilirubin levels. Neonatal massage, though not widely used, has been proven to promote excess bilirubin excretion, thus decreasing length of hospital stay; all the while, providing an intervention that allows parents to take an active role.