The experience of having a newborn baby – three times – had SGH neonatologist Dr Alvin Ngeow look for better and safer ways of screening infants for jaundice.
Dr Alvin Ngeow understands what new parents go through, having experienced it three times himself!
A neonatologist, specialising in the care of newborn infants,
Assistant Professor Ngeow recalled how he faced stress, fatigue and sleepless nights in the first few weeks of welcoming a new baby home. He also knows the hassle and inconvenience of taking leave to bring baby to hospital for tests, as well as the worry of exposing the infant to potential respiratory infections in the clinics or hospitals. Not surprisingly, his thoughts turned to how he can make things easier for new parents.
Dr Alvin with his three sons
Infant jaundice screening
Jaundice screening is an important test for newborns which typically involves frequent visits to a clinic or hospital. The condition, if not treated early, can cause brain damage and long-term complications like intellectual and motor disabilities, and developmental delays.
Jaundice affects 60 per cent of infants and 80 per cent of premature babies worldwide. Jaundice is a yellowing of the skin that occurs when babies’ little livers are not able to remove the bilirubin that builds up from the natural breakdown of red blood cells. Jaundice is usually self-limiting and bilirubin levels typically reach safe levels after the baby’s first two to three weeks.
Jaundice screening is typically done in hospitals or clinics where a light-emitting handheld gadget is used to measure the yellowness of their skin, or through a heel prick to obtain a blood sample.
A game-changing app for Asian newborns
Dr Ngeow gathered a team of SGH neonatalogists and paediatricians, SingHealth Polyclinics (SHP) family doctors and tech experts from the national HealthTech agency, Synapxe, to work together for a solution – a phone app known as
BiliSG© that parents can use to screen their newborns.
“The idea was to merge an age-old clinical skill that paediatricians call Kramer’s Rule with cutting-edge machine learning technology to come up with an innovative AI solution that parents can use with their smartphones to screen for infant jaundice,” said Dr Ngeow. Kramer’s Rule assesses the level of jaundice based on the yellowness of the skin and as the condition advances from the head (mild) to the chest (moderate) and tummy down to the toes (severe).
BiliSG© uses a machine learning model to predict bilirubin levels in multi-ethnic Asian newborns through skin colour analysis. Key to the app’s accuracy is the proprietary colour calibration card which adjusts the effect that different light conditions have on the skin colour so that the “true” colour of the skin is captured. Otherwise, data captured under different lightings – say, white or yellow light, or under bright or dimmed light -- might be skewed and suggest to the app that different babies are being photographed.
The team also wanted to capture more points on the body as “a newborn with jaundice can have varying degrees of yellowness in different parts of the body,” said Dr Ngeow. So BiliSG© takes three points of reference – the forehead, chest and abdomen – for analysis of the skin’s yellowness to predict bilirubin levels. This is unlike apps developed elsewhere for screening neonatal jaundice which measures only one point.
The app also considers unique skin tones, in the Asian context, versus the paler tones measured by apps developed elsewhere -- a factor that has bearing on accuracy.
To evaluate the app, the team did a study of the readings of almost 550 babies screened with the app, compared with existing methods of testing. The app proved to be as accurate as the gold standard, using blood tests.
The findings were published in JAMA Network Open, a peer-reviewed medical journal in December 2024.
“This novel tool will be a game changer in infant care in Singapore and beyond,” said senior author of the paper, Clinical Associate Professor (Dr) Tan Ngiap Chuan, Director of Research at SHP where the study was implemented.
(From left) A/Prof Tan and Dr Ngeow showcased their BiliSG© app at the AI Health Summit 2025
Moving forward, the team is conducting more comprehensive testing on multiple phone models and operating systems in a nationwide pilot involving more babies and the other paediatric hospitals in Singapore, as well as polyclinics.
Meanwhile, Dr Ngeow has become an ambassador of sorts for the app, which has drawn interest from around the region where families can live far from the nearest healthcare facilities. In February, he was in Jakarta to demonstrate BiliSG© to the Indonesian Ministry of Health, as well as the faculty of Universitas Indonesia, who are keen to validate the app on Indonesian babies.
Caption: Dr Ngeow (centre) and friends with their award-winning hamster habitat project.
Dr Ngeow’s latest innovation comes as no surprise to those who knew him. Even as a youth, he was already creating solutions to everyday problems, winning the prestigious Tan Kah Kee Young Inventor's Award for his "self-sustaining hamster habitat" - a clever system that made pet hamsters work for their food rather than relying on owners for regular feeding. In junior college, he represented Singapore at the Taiwan International Youth Science Competition, bringing home first prize for his research on "Screening for potential anti-fouling compounds in marine organisms".
Dr Ngeow the innovator has certainly come a long way.
