BIND score in severe hyperbilirubinemia

Bilirubin-induced neurologic dysfunction (BIND) Score is used to assess bilirubin induced encephalopathy in neonates with severe hyperbilirubinemia. Johnson et al developed the BIND score to help identify an infant who requires more aggressive monitoring and management.

Kernicterus MRI
Magnetic resonance imaging of the head. Hyperintense basal ganglia lesions on T2-weighted images [Gladys Cossio de Gurrola et al., CC BY 2.0, via Wikimedia Commons]

The scoring system has 3 parameters:

1. Cry pattern

2. Behavior and mental status

3. Muscle tone

bind scoring

BIND score = Total score (Points for all 3 parameters scored separately and added)


  • minimum score: 0
  • maximum score: 9
BIND ScoreStage
1 to 3Stage 1A
4 to 6Stage 1B
7 to 9Stage II

Stages of BIND:

Stage of BINDFeatures
IAminimal signs; totally reversible with therapy
IBprogressive signs but reversible with therapy
IIirreversible signs but severity decreased with prompt and aggressive therapy


Johnson L, Brown AK, Bhutani VK. BIND – A clinical score for bilirubin induced neurologic dysfunction in newborns. Pediatrics. 1999; 104 (Supplement): 746-747.

Resource for reading: 

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