Primary prevention
Appropriate support and advice to breastfeeding women, and increasing the frequency of breastfeeding to 8 to 12 times a day for the first few days, should be recommended.
Secondary prevention
In rare circumstances, depending on aetiology (e.g., in partial conjugation enzyme defects), if unconjugated bilirubin levels remain high, lifelong intermittent phototherapy is required to prevent neurological damage. High levels of unconjugated bilirubin can also lead to prolonged jaundice with conjugated hyperbilirubinaemia, and this will require specific treatment depending on the metabolic/genetic/surgical aetiology. Prevention of malnutrition and vitamin deficiencies is important in addition to promotion of bile flow and avoidance of bleeding. In one double-blind RCT, supplementation of Vitamin C in the final month of pregnancy had a decreasing effect on total serum bilirubin levels.[95]
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