Letters to the Editor

I welcome this opportunity to further discuss the criteria for the use of routine exchange transfusions in the premature infant with hyperbilirubinemia. Although it is well established that kernicterus due to "physiologic hyperbilirubinemia" can and does occur in the premature infant, its exact incidence in untreated premature infants is not known. Figures vary from 1 to 5% of all prematures. Even less understood, is the incidence of kernicterus in premature infants whose serum bilirubins reach 18 mg/100 ml or higher. Meyer states that 60% of prematures whose bilirubin reaches 18 mg/100 ml or higher will develop kernicterus.