The revised American Academy of Pediatrics’ (AAP’s) guideline for the management of hyperbilirubinemia in infants ≥35 weeks’ gestation, published in the July issue, provides a contemporary evidence-based approach to a condition that affects the majority of otherwise healthy newborns. Adherence by clinicians to the recommendations is expected to prevent most cases of kernicterus, the devastating, irreversible neurologic damage associated with excessive serum levels of bilirubin.

Despite the publication of a previous version of the guideline in 1994, kernicterus continues to occur. Many contributing factors may be at play. For example, the change to early discharge, often at <48 hours after birth, disrupted the previous patterns of care associated with a longer postpartum hospitalization. As a result, newborns now experience the usual peak of serum bilirubin concentration, at 3 to 5 days of age, at home rather than observed by clinicians in the nursery as in previous times....

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