Jaundice is the yellow colour of the skin and the whites of the eyes that you may notice in your baby in the first days of life. It is very common: around 60% of full-term babies and 80% of premature babies develop some degree of jaundice in the first week. In most cases, it is mild and clears up on its own.
A small number of babies need treatment for jaundice, usually with light therapy (phototherapy). This page explains what jaundice is, when it’s normal, when to seek help, and how it’s treated.
Jaundice is caused by bilirubin, a yellow pigment that comes from the natural breakdown of red blood cells. Before birth, your baby’s red blood cells are slightly different to your own. After birth, the body breaks down these cells and replaces them with adult-type red blood cells. The bilirubin released has to be processed by the liver, but a newborn’s liver is still maturing in the first days, so bilirubin builds up faster than it can be removed.
The result is a yellow tinge to the skin and the whites of the eyes. Jaundice usually appears between days 2 and 4, and clears within 1 to 2 weeks for most babies.
When: Appears on day 2 to 4, peaks at day 4 to 5, and clears by day 10 to 14.
The most common type. It is the natural result of a maturing liver clearing bilirubin. No treatment is needed for most babies; just regular feeds, normal observation, and time.
When: In the first week, when feeding is still being established.
When a breastfed baby isn’t yet getting quite enough milk, the bilirubin builds up. The treatment is better feeding, not stopping breastfeeding. A lactation consultant can help.
When: In the first 24 hours of life, or persisting beyond 2 weeks, or with very high levels.
Less common, but more serious. Possible causes include blood group incompatibility, infection, or liver problems. Investigated and treated promptly. Your team will explain the cause and the plan.
Body: Checking: Your midwife will look at your baby’s skin in good natural light, paying attention to the face first, then the chest and limbs. If jaundice is suspected, a bilirubin level can be measured either with a small skin-test device or a heel-prick blood test.
Treatment: Most babies don’t need treatment beyond good feeding and normal observation. If the bilirubin level is high enough to need treatment, your baby may be offered phototherapy:
Feeding continues throughout. Most babies finish phototherapy within 1 to 2 days. In very rare cases of very high bilirubin levels, a blood exchange transfusion may be needed.
Trust your instincts. If something doesn’t seem right, ring.
For the great majority of babies, no. Mild physiological jaundice is harmless and clears on its own. Severe untreated jaundice can, very rarely, cause damage to the brain (kernicterus), which is why we monitor closely and treat when levels reach a certain threshold.
No. Phototherapy is safe, has been used for decades, and is well-tolerated. The eye shields protect baby’s eyes; aside from this, your baby will simply rest and feed.
No. Continue breastfeeding, and feed often. In some cases, a top-up of expressed milk or formula may be advised in addition to breastfeeding, to help things along. Your team will explain if this applies.
Brief, indirect sunlight (next to a window with the baby dressed appropriately) doesn’t do harm, but it is not a substitute for treatment if the level is high. Never place a baby in direct sunlight; they overheat and burn quickly.
Sometimes. If your baby’s level is borderline at discharge, we may ask you to bring baby back for a repeat check the next day. This is routine and reassuring rather than alarming.
Prolonged jaundice (beyond 2 weeks in a term baby) does need to be looked at, even if your baby seems well. Most causes are benign (continuing “breast milk jaundice”), but some need investigation. Your GP or public health nurse will arrange the appropriate checks.
