Sara -
How wonderful that this baby has such a well-informed dad!  Yes, it is true
that normal bili levels vary by population.  Asian and Native American
populations do tend to have bili levels higher than white infants.  This can
also occur in some African Americans because there may be Native American
ancestry.
In Ruth Lawrence p 448 "There is an increased incidence of elevated bilirubin
levels in certain and races and populations.  Asian populations - including
Chinese, Japanese and Korean - and American Indians may have bilirubin levels
averaging between 10 and 14 mg/100 ml.  There is also a higher incidence of
autopsy-identified kernicterus in these populations."  I think she's being
pretty conservative.
In Riordan/Auerbach p 335 "Different racial groups appear to exhibit neonatal
hyperbilirubinemia in varying degrees.  Horiguchi and Bauer reported that
Japanese neonates were more than three times as likely as Caucasians newborns
to have jaundice - defined as a serum bilirubin level >10 mg/dL.....Similar
patterns have occurred when comparing other Asian neonates (for example,
Chinese and Korean) with Caucasian infants.... Higher neonatal bilirubin
levels in these groups may therefore be normal and should not precipitate
intervention."  They go on to say that  if newborn is 24 hrs of age or older a
bili of over 18 in Asian babies may be justification for a Coombs test.  "If
infant is not anemic and the Coombs test is negative, there is negative, there
is little justification for ordering additional tests" R&A, p 339.
It was my understanding that bilis of 20 are pretty normal in Asian
populations.
Cynthia D. Payne
LLL of Berkshire County MA