Population	Healthy term or near-term infants at least 35 weeks' gestation
Recommendation	No recommendation because of insufficient evidence
Recommendation	I statement: insufficient evidence
Risk assessment	Risk factors for hyperbilirubinemia include family history of neonatal jaundice, exclusive breastfeeding, bruising, cephalohematoma, ethnicity (Asian or black), maternal age older than 25 years, male sex, glucose-6-phosphate dehydrogenase deficiency, and gestational age less than 38 weeks. The specific contribution of these risk factors to chronic bilirubin encephalopathy in healthy children is not well understood.
Importance	Chronic bilirubin encephalopathy is a rare but devastating condition. Not all children with chronic bilirubin encepahalopathy have a history of hyperbilirubinemia.
Rationale for no recommendation	Evidence about the benefits and harms of screening is lacking. Therefore, the USPSTF could not determine the balance of benefits and harms of screening newborns for hyperbilirubinemia to prevent chronic bilirubin encephalopathy.
Considerations for practice	In deciding whether to screen, physicians should consider the following: Potential preventable burden. Bilirubin encephalopathy is a relatively rare disorder. Hyperbilirubinemia alone does not account for the neurologic condition of chronic bilirubin encephalopathy. There is no known screening test that will reliably identify all infants at risk of developing chronic bilirubin encephalopathy. Potential harms. The potential harms of screening are unmeasured but may be important. Evidence about the potential harms of phototherapy is lacking. Harms of treatment by exchange transfusion may include apnea, bradycardia, cyanosis, vasospasm, thrombosis, necrotizing enterocolitis, and, rarely, death. Current practice. Universal screening is widespread in the United States.
Screening tests	Screening may consist of risk-factor assessment, measurement of bilirubin level in serum or by transcutaneous estimation, or a combination of methods.
Interventions	Phototherapy is commonly used to treat hyperbilirubinemia. Exchange transfusion is used to treat extreme hyperbilirubinemia.
Relevant USPSTF recommendations	USPSTF recommendations on screening newborns for hearing loss, congenital hypothyroidism, hemoglobinopathies, and phenylketonuria can be found at http://www.preventiveservices.ahrq.gov.