60% of normal newborns become clinically jaundiced during the first week of life. Unconjugated (indirect) hyperbilirubinemia occurs as a result of excessive bilirubin formation and because the neonatal liver cannot clear bilirubin from the blood rapidly enough. Although most newborns with jaundice are otherwise healthy, they need to be monitored because bilirubin is potentially toxic to the central nervous system. Sufficiently elevated levels of bilirubin can lead to bilirubin encephalopathy and subsequently kernicterus, with devastating, permanent neurodevelopment handicaps. Fortunately, current interventions make such severe sequelae rare. But because neonatal jaundice is so common, many infants-even those who are unaffected-are monitored and treated to prevent substantial damage that would otherwise occur in a few cases.
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