A Practical Approach to Neonatal Jaundice

lthough jaundice is present in most newborns and is usually benign, it is imperative to carefully monitor newborns to identify those at risk of developing bilirubin-induced neurologic dysfunction. Acute bilirubin encephalopathy is caused by the toxic effects of unconjugated bilirubin on the central nervous system. Symptoms include lethargy, high-pitched cry, and poor feeding in a jaundiced infant. If acute bilirubin encephalopathy is untreated, it may progress rapidly to advanced manifes-tations, such as opisthotonus and seizures.1 Kernicterus is the chronic, permanent clini-cal sequelae of bilirubin toxicity; it is char