Jaundice in Newborns

Overview

What is jaundice in newborns?

Jaundice in newborns is the yellow coloring in an infant’s skin. Jaundice occurs when bilirubin (pronounced “bil-ih-ROO-bin”) builds up in your baby’s blood. Hyperbilirubinemia is the medical term for this condition.

Bilirubin is a yellow substance your body creates when red blood cells break down. While you’re pregnant, your liver removes bilirubin for your baby. But after birth, your baby’s liver must begin removing bilirubin. If your baby’s liver isn’t developed enough, it may not be able to get rid of bilirubin. When excess bilirubin builds up, your baby’s skin may appear yellow.

Jaundice in infants is common. It’s usually not serious and goes away within a couple of weeks. But it’s important for your baby’s healthcare provider to check them for jaundice. Severe jaundice can lead to brain damage if it goes untreated.

What are the different types of newborn jaundice?

There are a few different types of jaundice in newborns.

Physiological jaundice

The most common type of jaundice in newborns is physiological jaundice. This type of jaundice is normal. Physiological jaundice develops in most newborns by their second or third day of life. After your baby’s liver develops, it will start to get rid of excess bilirubin. Physiological jaundice usually isn’t serious and goes away on its own within two weeks.

Breastfeeding jaundice

Jaundice is more common in breastfed babies than formula-fed babies. Breastfeeding jaundice frequently occurs during your baby’s first week of life. It happens when your baby doesn’t get enough breast milk. It can occur due to nursing difficulties or because your milk hasn’t come in yet. Breastfeeding jaundice may take longer to go away.

Breast milk jaundice

Breast milk jaundice is different than breastfeeding jaundice. Substances in your breast milk can affect how your baby’s liver breaks down bilirubin. This can cause a bilirubin buildup. Breast milk jaundice may appear after your baby’s first week of life and may take a month or more to disappear.

Other types of jaundice can occur if your baby has an unrelated medication condition.

How common is jaundice in newborns?

Jaundice in newborns is a very common condition. Up to 60% of full-term babies develop jaundice during their first week of life. As many as 80% of premature babies develop jaundice during their first week of life.

Symptoms and Causes

What are the signs and symptoms of jaundice in newborns?

The main sign of jaundice is the yellowing of your baby’s skin. You can see it best in natural lighting, such as in front of a window. It usually appears in your baby’s face first. The whites of your baby’s eyes and under their tongue may look yellow. As the level of bilirubin increases, the yellowing may move to your baby’s chest, belly (abdomen), arms and legs.

Jaundice may be difficult to see if your baby has darker skin. But you should still be able to tell if your baby has jaundice by the color of their eyes and under their tongue.

What causes jaundice in newborns?

Jaundice happens when your baby’s blood has too much bilirubin. Bilirubin is a chemical your body makes when it breaks down old red blood cells. Your liver normally filters bilirubin from your blood. Your body gets rid of it when you poop.

If your baby’s liver hasn’t developed enough to get rid of bilirubin, it can start to build up. This buildup of bilirubin causes your baby’s skin to look yellow. Most babies develop jaundice in their first few days of life. This is because it takes a few days for your baby's liver to develop and get better at removing bilirubin.

Severe jaundice can occur if your baby has:

Diagnosis and Tests

How is jaundice in newborns diagnosed?

Your baby’s healthcare provider will check for signs of jaundice while you’re still in the hospital. Your baby’s bilirubin level will be highest when they’re three to five days old. It’s important that your baby’s healthcare provider checks them again within this time frame.

Your baby’s healthcare provider can estimate your baby’s bilirubin level by placing a probe on your baby’s head. This test shows the transcutaneous bilirubin (TcB) level. If this level is high, your baby’s healthcare provider will order a blood test to confirm the results. They’ll prick your baby’s heel to collect a small sample of blood. The blood test shows the total serum bilirubin (TSB) level.

The American Academy of Pediatrics uses a newborn jaundice level chart to determine if a baby needs treatment. The chart is based on your baby’s total serum bilirubin level and age.

Total serum bilirubin (TSB) levelAge of newborn
Above 10 milligramsLess than 24 hours old
Above 15 milligrams24 to 48 hours old
Above 18 milligrams49 to 72 hours old
Above 20 milligramsOlder than 72 hours.

Management and Treatment

How is jaundice in newborns treated?

Treatment for jaundice in newborns isn’t usually necessary. Mild levels of jaundice typically go away on their own as your baby’s liver continues to develop. This can take one to two weeks. Feeding your baby often (10 to 12 times a day) can encourage pooping (bowel movements). This helps your baby rid their body of the excess bilirubin.

If your baby’s bilirubin level is high or continues to rise, their healthcare provider may recommend phototherapy treatment. During phototherapy, your baby will be undressed and placed under special blue lights. They’ll wear only a diaper and a mask to protect their eyes. Phototherapy helps your baby’s liver get rid of excess bilirubin. The lights won’t harm your baby. Phototherapy treatment takes one to two days. If your baby’s bilirubin levels aren’t too high, you may be able to treat your baby with light therapy at home.

In rare cases when phototherapy doesn’t work, your baby’s healthcare provider may recommend an exchange transfusion. With an exchange transfusion, some of your baby’s blood is replaced with fresh, donated blood.

Prevention

How can I prevent jaundice in my newborn?

Jaundice in newborns is normal and usually can’t be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin.

  • Breastfed babies: You should breastfeed your baby eight to 12 times a day during their first week of life.
  • Formula-fed babies: You should give your baby one to two ounces (30 to 60 milliliters) of formula every two to three hours during their first week of life. Ensure at least eight feeds in a 24-hour period.

Also, make sure your baby’s healthcare provider checks your baby’s bilirubin level before you leave the hospital. Schedule a follow-up visit during your baby’s first week of life to have the bilirubin level checked again.

Outlook / Prognosis

How long does jaundice in newborns last?

Jaundice in newborns is normal. It usually develops by their second or third day of life. In formula-fed babies, jaundice typically goes away on its own within two weeks. In breastfed babies, jaundice can last a month or longer.

What is the outlook for jaundice in newborns?

Jaundice in newborns is common. For most babies, jaundice will get better without treatment within one to two weeks. But it’s important to have your baby’s bilirubin level checked. A high bilirubin level can lead to serious health conditions if it’s not treated immediately. These conditions include cerebral palsy, deafness and kernicterus, a type of brain damage.

Living With

When should my baby see their healthcare provider?

You should return for a visit with your baby’s healthcare provider shortly after leaving the hospital. Your baby’s bilirubin level will be at its highest when they’re between three and five days old. The timing of your visit will depend on your baby’s age when you left the hospital, their bilirubin level when you left the hospital and other factors.

When should I call my baby’s healthcare provider?

You should contact your baby’s healthcare provider if their jaundice increases or lasts longer than two weeks. Symptoms of severe jaundice may include:

  • Your baby’s skin turns brighter yellow or orange.
  • Your baby is very sleepy, including difficult to wake for feeds.
  • Your baby is very fussy.
  • Your baby isn’t nursing well or sucking from a bottle well.
  • Your baby isn’t making enough wet and/or dirty diapers.

When should I go to the ER?

Call 911 or go to your nearest emergency room if your baby has a:

  • High-pitched cry.
  • Fever.
  • Arched body (head/neck or heels bent back and body forward).
  • Stiff, limp or floppy body.

What questions should I ask my baby’s healthcare provider?

Jaundice in your newborn can be alarming. It’s normal to have questions if your baby develops jaundice in the hospital or after you’ve left for home. Common questions you may want to ask their healthcare provider include:

  • How can I tell if my baby has jaundice?
  • What complications can occur from jaundice?
  • Will my baby need treatment for jaundice?
  • Can I treat my baby’s jaundice at home?
  • Can phototherapy harm my baby?
  • How long does it take for jaundice to go away?
  • When should we return for a follow-up visit?

A note from Cleveland Clinic

You may be a little worried if your baby looks yellow, but jaundice is a very common condition in newborns. Your baby’s healthcare provider should check your baby’s bilirubin level before you leave the hospital and again within five days of birth. While jaundice is usually not serious, it can be dangerous if not treated properly. If your newborn baby’s jaundice hasn’t improved or seems worse, call your baby’s healthcare provider right away. They can give your baby another bilirubin test to ensure they’re on their way to good health.

Last reviewed by a Cleveland Clinic medical professional on 01/17/2022.

References

  • American Academy of Family Physicians. Evaluation and Treatment of Neonatal Hyperbilirubinemia. (https://www.aafp.org/afp/2014/0601/p873.html) Accessed 1/17/2022.
  • American Academy of Family Physicians. Infant Jaundice. (https://familydoctor.org/condition/infant-jaundice/) Accessed 1/17/2022.
  • American Academy of Pediatrics. Jaundice in Newborns: Parent FAQs. (https://www.healthychildren.org/English/ages-stages/baby/Pages/Jaundice.aspx) Accessed 1/17/2022.
  • American Liver Foundation. Jaundice In Newborns. (https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/newborn-jaundice/#information-for-the-newly-diagnosed) Accessed 1/17/2022.
  • Centers for Disease Control and Prevention. Jaundice and Kernicterus Information for Families. (https://www.cdc.gov/ncbddd/jaundice/families.html) Accessed 1/17/2022.
  • Newborn jaundice. (https://medlineplus.gov/ency/article/001559.htm) Accessed 1/17/2022.
  • Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935699/) Iran J Public Health. 2016;45(5):558-568. Accessed 1/17/2022.

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