At 2 days old, Taylor Beekman's skin coloring looked fine, but as a part of routine newborn care, Henrico Doctor's Hospital nurse manager Cory Geary checked her for jaundice.

Geary placed a hand-held meter against the baby's forehead. The meter would give a numerical score that would be plotted on a chart that helps doctors and nurses screen babies for risk of jaundice complications.

Taylor looked fine. Parents Dustin and Amber Beekman took her home with instructions that included information on scheduling the baby's first visit with a pediatrician, which is determined in part by the results of the jaundice screening.

Jaundice screening of newborns, once done as informally as a doctor or nurse pressing a finger to the baby's skin to check for yellowish tones in underlying skin and tissue, is now more standardized and routine, done with meters that can correct for darker-colored skin tones and with reference charts that alert health-care workers when the screening reading signals the need for heightened concern.

The standardization is an attempt to prevent a rare complication of untreated jaundice in newborns called kernicterus, which can cause irreversible brain damage and death. Hearing problems and muscle spasms are also potential problems. Very few cases of kernicterus are reported in the United States each year, but those that are are especially tragic because excessive jaundice in newborns is easily treated by using photolight therapy.

"Many physicians will say they have never seen kernicterus," said Dr. Adam M. Falik, vice chairman of the Pediatrics Department at Henrico Doctors' Hospital. "It does happen."

Because it does, the American Academy of Pediatrics last year issued revised recommendations for screening babies for jaundice. The new guidelines take into account that most newborns go home within 48 hours of being born -- which can be too early for evidence of severe jaundice to show up. Although a little jaundice is common in newborns and usually goes away on its own, some babies need treatment.

The guidelines also take into account the fact that more women are breast-feeding. Babies who are not getting enough milk are at higher risk of excessive jaundice, which happens when bilirubin, a substance made by the liver, is not efficiently broken down and excreted. That buildup of bilirubin causes the yellow tint in the skin. Too much can be dangerous. Women new to breast-feeding may not know how to monitor how much milk their babies are getting. The American Academy of Pediatrics says newborns should breast-feed at least eight to 12 times a day for the first few days.

"The more the baby eats, the more hydrated they are, the better they eliminate [bilirubin] in their stools," said Dr. Linda D. Meloy, an associate professor of pediatrics at Virginia Commonwealth University.

"There are some babies because of a genetic background or breast milk taking a little time to come in, there are all these reasons that they would get jaundice," said Meloy.

In line with the new recommendations, all area hospitals do bilirubin screenings on newborns.

HCA Inc., which owns Henrico Doctors' Hospital, CJW Medical Center and John Randolph Medical Center, screens all its babies using the skin meters. So does VCU Medical Center.

Bon Secours' hospitals, which include St. Mary's and Memorial Regional Medical Center, test blood taken during blood draws for other newborn screenings, said Dr. Bonnie Makdad, director of neonatology for that health system.

"We get the results in about 30 minutes," said Makdad. They don't use the skin meters, she said, because the blood screening would have to be done anyway if the skin screening raised a red flag.

All the numbers are plotted against a chart that compares the age of the baby against the screening reading. Doctors use that chart to advise parents how soon a baby should have its first visit to a pediatrician. It could be the next day, or two or three days later.

"Typically when the baby used to have the first visit to the doctor, that used to be two weeks," said Meloy. "The guidelines that came out last July, they want that first visit much earlier. An infant discharged before 24 hours should be seen by age 72 hours."

Along the same lines, a baby discharged 25 to just under 48 hours after birth should be seen by a pediatrician by the time the baby is 96 hours old. Babies discharged from 48 to 72 hours after birth should be seen by a pediatrician by the time they are 120 hours old.

"That's a radical difference," said Meloy. "When the guidelines came out last July there was a huge scramble to get babies in sooner. . . . It's preventable. That is why they are so after this. We don't want to scare mothers. We want every mother and father to know this is a possibility. If they see their child getting yellow, they need to act on it. Don't think this is a normal part of infancy."

The Beekmans were familiar with the need for jaundice screening. They went through the same thing with their older child, Maddox, who just turned 2 years old. He was a little jaundiced as a newborn and spent a couple of extra days in the hospitals being treated with light therapy.

Connie Beekman, the children's grandmother, was able to provide some perspective on how medical practice changes. When she had her children in the 1970s, mothers stayed longer and doctors routinely ordered them to stay even longer.

"Both of my children had jaundice," said Beekman. "My pediatrician said that baby looks a little yellow, you need to stay," she recalled being told.

"I was not sure what the effects of it were. I never knew the repercussions of it not being treated."