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Risk assessment and follow-up are the keys to preventing severe hyperbilirubinemia.

In July 2004, the American Academy of Pediatrics Subcommittee on Hyperbilirubinemia published its clinical practice guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.1 Although addressed primarily to a North American audience, this guideline has been accessed electronically more often than almost any other publication in Pediatrics and the key elements have been implemented in virtually every corner of the globe. The purpose of the guideline was to help the clinician implement the basic tools of identification, surveillance, and follow-up of the jaundiced newborn in order to reduce the risk of severe hyperbilirubinemia, and the guideline recommended the implementation of 10 key elements to achieve this objective.1 If I had to identify two of the recommendations listed as the most important in achieving this goal, I would select those that call for a systematic risk assessment on every infant before discharge from the nursery and the provision of appropriate follow-up based on the time of discharge and this risk assessment.