Kernicterus is a preventable but devastating neurologic disorder with life long complications. It is caused by severe and inadequately treated hyperbilirubinemia during the newborn period. In the present paper potential causes and risk factors for the occurrence of kernicterus related to the Thai health system that are responsible for the care of newborn infants before and after discharge are discussed. Potential risk reduction strategies for the Thai health system are purposed Some efforts to improve the quality of Thai newborn care particularly newborns with jaundice that have been made are mentioned. An adherence to the American Academy of Pediatrics clinical guideline for management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation for those strategies that are feasible to follow will help reduce the prevalence of severe hyperbilirubinemia and bilirubin encephalopathy.