Which of the following should be recommended for a newborn with hyperbilirubinemia?

In the management of a newborn with hyperbilirubinemia, the primary treatment often recommended is phototherapy, as it effectively reduces bilirubin levels by converting the bilirubin into a more water-soluble form that can be excreted. Vitamin E may be included in some protocols as it is an antioxidant that may help mitigate oxidative stress; however, it doesn't directly treat hyperbilirubinemia.

In cases where phototherapy is insufficient to lower bilirubin levels, or if the bilirubin levels are critically high, exchange transfusion may be warranted. This procedure helps remove the excess bilirubin and any potential antibodies causing hemolysis, thereby lowering the risk of bilirubin-induced complications.

While nasal CPAP is useful for managing respiratory distress in newborns, it does not address the primary issue of hyperbilirubinemia and is not a routine recommendation for this condition. Therefore, combining phototherapy with Vitamin E and exchange transfusion provides a comprehensive approach to managing the raised bilirubin levels and their potential consequences. Thus, the correct recommendation for treating a newborn with hyperbilirubinemia is phototherapy, Vitamin E, and exchange transfusion.