Neonatal jaundice (NNJ), a transitional phenomenon, affects a majority of newborns. They mostly are associated with benign consequences in the first week of life and typically resolves within 3 to 5 days without significant complications in the absence of comorbid prematurity, sepsis, or hemolytic disorders. 

Severe NNJ may cause bilirubin-induced mortality or long-term neurodevelopmental impairments. Thus it is necessary to effectively evaluate it and treat. But the global burden of disease (GBD) NNJ remains mostly unknown. Bhutani et al explained it for the first time in 2013 as Extreme hyperbilirubinemia (total plasma and serum bilirubin >25 mg/dL) to affect 481000 late-preterm and term neonates annually. 114000 of them dying and >63 000 surviving with moderate/severe long-term neurologic impairments. 

The GBD 2016 report rendered NNJ prevention to be important in the first week of life in Sub-Saharan Africa and South Asia, including countries with the highest global burden of neonatal mortality. 

Prevention of NNJ completely in newborns remains impossible, but timely interventions can arrest its progression to the more debilitating stage of kernicterus, reduce the mortality and long-term neurologic impairments faced by survivors. 

Timely access to effective phototherapy is important to curb excessive rates of exchange transfusion and bilirubin-induced mortality in high-burden countries. Mothers should be empowered to recognize the onset of severe NNJ and encouraged to seek professional care immediately. Effective prenatal and public education is necessary to explain the potential dangers of exposure to oxidative agents and delayed or inappropriate treatment. There must be a provision of simple-to-use tools to detect severe NNJ at home to prevent the onset of acute bilirubin encephalopathy. 

Incidence of hemolytic jaundice should be reduced with-

• Routine screening for glucose 6-phosphodehydrogenase deficiency, 
• strict antiseptic adherence to avoid neonatal infections,  
• Control of rhesus (Rh) isoimmunization with Rh-immunoglobulin prophylaxis for Rh-negative mothers. 

A global effort is needed to make available bilirubin measuring devices and phototherapy units at hospitals and homes. Tropical, rural communities with limited access to electricity should utilize heliotherapy (using filtered sunlight) to prevent fatal outcomes.