Screening for severe neonatal hyperbilirubinemia

Screening for severe neonatal hyperbilirubinemia is integral to newborn care. Predischarge risk assessment relies on documentation of visual jaundice: age at onset and progression; identification of clinical risk such as late prematurity and bruising; with determination of total bilirubin (blood or transcutaneous assay) adjusted for age in hours. Along with promotion of breastfeeding, coordination between birthing hospital and medically supervised outpatient follow-up, a systems approach allows for a safer and effective means to prevent adverse effects of extreme hyperbilirubinemia.