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