Safe bilirubin level for term babies with non-hemolytic jaundice.

Dhaded et al.(1) have recommended a cut-off level of 20 mg/dl for exchange transfusion in term babies with nonhemolytic jaundice. This is based on their observations that 21 out of 86 (25.8%) babies with bilirubin level of more than 20 mg/dl developed kernicterus in their study group. It is well known that apart from bilirubin levels per se, many other factors determine bilirubin toxicity. As the babies in the study were referred from other hospitals for treatment of jaundice, it is likely that details of risk factors may not have been known. No specific mention has been made about the presence or absence of risk factors except in 2 babies with birth asphyxia who developed kernicterus with bilirubin level of more than 20 mg/dl.