In their study of the routine use of transcutaneous bilirubin (TcB) measurements in 27 well infant nurseries, Taylor et al found that 2.2% of TcB measurements underestimated the clinical laboratory measurement of total serum bilirubin (TSB) by ≥3.0 mg/dL, and the tendency for TcB to underestimate TSB increased with advancing newborn age (presumably up to the length of stay of a normal newborn). They nevertheless conclude that TcB measurements “provide reasonably accurate estimates of TSB values” and work well enough as a method for identifying significant hyperbilirubinemia.

Because many nurseries now follow the recommendation to screen all infants with a TSB or TcB before discharge, it is important to know whether we can rely on the TcB as a screening measurement. Although some 30 years of worldwide experience with this technique have been largely rewarding, most of the published data come from research studies where attention is...

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