In 1994 the American Academy of Pediatrics recommended more liberal rules for 
the treatment of hyperbilirubinemia in healthy term newborns. Yet, the safety of 
moderate degrees of hyperbilirubinemia in healthy term newborns is debated. To 
evaluate the safety of moderate degrees of hyperbilirubinemia, we assessed 
neurologic condition of 20 healthy nonhemolytic term newborns with peak total 
serum bilirubin levels of 233-444 micromol/L and 20 control infants matched for 
sex and gestational age at birth. Neurologic condition was evaluated with 
techniques focusing on the presence of minor neurologic dysfunction: in the 
newborn period according to Prechtl, at 3 mo on the basis of the quality of 
general movements, and at 12 mo according to Touwen. Moderate hyperbilirubinemia 
turned out to be associated with a significant increase in minor neurologic 
dysfunction throughout the first year of life. At 12 mo a strong dose-response 
relationship between the degree of hyperbilirubinemia and the severity of minor 
neurologic dysfunction was present. Our results indicate that total serum 
bilirubin levels 335 micromol/L should be avoided.