Discharging the Jaundiced Infant From the Hospital: Risky for the Infant or Physician?

To the Editor.— Term infants with idiopathic unconjugated hyperbilirubinemia who are otherwise well are probably at less risk for bilirubin encephalopathy than they are for having congenital hypothyroidism or galactosemia. Because approximately 10% of children have a neurologic deficit of some type, however, it is tempting to blame such deficits on newborn jaundice, particularly if the parents perceive (often in retrospect) that the attending physician was not sufficiently attentive to the problem. Social and financial pressures have minimized the hospital stay of newborns, resulting in increased risk for undetected hyperbilirubinemia with subsequent increased risk for litigation should a jaundiced infant manifest neurologic or developmental handicaps.