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Jaundice is a
condition that makes a newborn's skin and the white part of the eyes look
yellow. It happens because there is too much
bilirubin in the baby's blood (hyperbilirubinemia).
Bilirubin is a substance that is made when the body breaks down old
red blood cells.
Jaundice usually is not
a problem. But in rare cases, too much bilirubin in the blood can cause brain
damage (kernicterus). This can lead to hearing loss, intellectual disability, and other problems.
In healthy babies, some
jaundice almost always appears by 2 to 4 days of age. It usually gets better or
goes away on its own within a week or two without causing problems.
In breast-fed babies, mild jaundice sometimes lasts until 10 to 14 days
after birth. In some breast-fed babies, it goes away and then comes back.
Jaundice may last throughout breast-feeding. This isn't usually a problem as
long as the baby gets enough milk by being fed at regular times.
Babies who have jaundice need a follow-up exam within the first 5 days after birth. Before or after that visit, your doctor may ask you to watch for signs that the jaundice is going away or to bring your baby in for a test to check if the jaundice is getting better. Call your doctor if the yellow color gets
brighter after your baby is 3 days old.
because your baby's body has more bilirubin than it can get rid of. Bilirubin
is made when the body breaks down old red blood cells. It leaves the body
through urine and stool. During pregnancy, your body removes bilirubin from
your baby through the
placenta. After birth, your baby's body must get rid
of the bilirubin on its own.
Breast-fed newborns can become
dehydrated easily if feedings are spaced too far
apart. This lack of enough milk in the body makes it harder for your baby to
get rid of wastes such as bilirubin. Also, some of the things that make up
breast milk can change the way the body removes bilirubin.
cases, too much bilirubin may be caused by infections, a problem with the
baby's digestive system, or a problem with the mom's and baby's blood types
(Rh incompatibility). Your baby may have one of these
problems if jaundice appears less than a day after birth.
Jaundice can make your
baby's skin and the white part of the baby's eyes look yellow. You may see the
yellow color between 1 and 4 days after birth. It shows up first in the baby's
face and chest. Babies who have bilirubin levels that are too high may have a
high-pitched cry. They also may be sluggish and cranky.
doctor will do a physical exam and ask you questions. The doctor may ask
A blood test for bilirubin may be done to find out if
your baby needs treatment.
More tests may be done if the doctor
thinks that a health problem is causing too much bilirubin in the blood.
Most of the time no treatment
is needed for jaundice, because it usually goes away on its own. If you are
breast-feeding, you may be able to help reduce the jaundice by feeding your
baby about 8 to 12 times a day.
Sometimes babies with jaundice
are put under a type of fluorescent light. This is called
phototherapy. The skin absorbs the light. This changes
the bilirubin so that the body can more easily get rid of it in the stool and
urine. The treatment is usually done in a hospital. But babies sometimes are
treated at home.
If a health problem caused the jaundice, your
baby may need other treatment.
Frequently Asked Questions
Learning about jaundice in newborns (hyperbilirubinemia):
Living with jaundice in newborns:
Your newborn's skin and white
part of the eyes will look yellow if he or she has jaundice. This yellow tint
usually appears first in the infant's face and chest between 1 and 5 days after
birth, although the exact timing may vary by child and by the
type of jaundice.
damage (kernicterus) can develop if a baby with a high
bilirubin blood level is not treated. See your doctor right away
if your baby develops signs of a high bilirubin level, which include:
Signs of a very high level of
bilirubin may include:
Your baby's doctor will do a physical
exam and take a medical history to diagnose
jaundice (hyperbilirubinemia). As part of the medical history, the doctor
may ask questions about:
During the exam, the doctor will check your baby's skin
color. This may include pressing a finger lightly on your baby's skin. The
doctor will note whether yellowing related to jaundice is visible only in the
eyes, face, and head or if it is also noticed on the chest and lower body. He
or she may also look for signs of
underlying conditions that can cause jaundice.
The doctor or nurse may place a device (transcutaneous meter) gently against your baby's skin to check your baby's
bilirubin level. If the results are concerning, a
bilirubin test may be done to more precisely measure
the bilirubin level in your baby's blood. The results will help your baby's
doctor decide whether treatment is needed.
If the doctor thinks
that another condition is causing your baby to have too much bilirubin in the
blood, more tests may be done. For example, the doctor may
blood type tests if the cause of hyperbilirubinemia
could be that you and your baby have different blood types (ABO or Rh
Many mothers and their newborns leave the
hospital within 48 hours of the baby's birth, often before signs of jaundice
start. Your baby needs a follow-up exam within the first 5 days after birth.
Call your baby's doctor if at any time you notice a yellow tinge to your baby's
skin and eyes.
Most of the time no medical
treatment is needed for
jaundice in a newborn (hyperbilirubinemia). But watch
for increasing intensity of the yellow tint in the skin and eyes or any change
in your baby's behavior.
Babies who have
bilirubin in their blood at a level that could be
harmful need treatment. Whatever the cause, if the condition is not treated,
too much bilirubin in the blood may lead to brain damage (kernicterus), which could result in hearing loss,
intellectual disability, and other problems.
If your baby needs treatment, he or she will likely have phototherapy. It uses a type of fluorescent light to help your baby's body get rid of bilirubin. Standard
phototherapy is usually done in a hospital. But babies with jaundice who are
otherwise healthy may be treated at home with a type of phototherapy that uses
a fiber-optic wrap, usually a blanket or a band.
If your newborn is receiving phototherapy for jaundice in the hospital,
you can help by:
The fluorescent lights used in phototherapy for babies with
jaundice are not harmful if precautions are taken. Eye shields are placed over
the baby's eyes to protect them while under the light. The shields are removed
during feedings. Babies are accustomed to being in the dark after months in the
womb, so the shields should not bother your baby.
If the baby's jaundice is being caused by
an underlying condition, other treatments may be needed. For example, if
severe jaundice is caused by the baby's body destroying red blood cells (blood
type incompatibility), the baby may need
immunoglobulin (IG). If that doesn't help, the baby
may need to be admitted to a hospital and given a
Parents are often asked to watch their
newborns for signs of
jaundice, which produces a yellow tint to the skin and
eyes. Many mothers and their newborns leave the hospital within 48 hours of the
baby's birth, often before signs of jaundice develop. It is recommended that
your infant have a follow-up exam with your doctor within the
first 5 days after birth.
If your baby has jaundice but does not
need phototherapy, your baby's doctor will ask you to watch
for and report any signs of increasing jaundice or changes in behavior. To
check for signs of increasing jaundice:
The best home treatment for jaundice is making sure your baby gets enough to eat. This can provide him or her with the fluids needed to get rid of
the extra bilirubin.
Babies with jaundice who are otherwise healthy may be
treated at home with a type of phototherapy that uses a fiber-optic wrap,
usually a blanket or a band. These wraps usually reduce blood bilirubin levels
more slowly than standard phototherapy, so generally they are used only for
mild jaundice. Sometimes standard therapy and fiber-optic wrap therapy are used
If your baby is being treated
at home for jaundice, be sure you understand how to use all of the
equipment. Ask your baby's doctor for help if you have questions or concerns.
You may need to take your baby to a lab each day to get his or her bilirubin
checked. A home health nurse may visit to make sure all is going well.
If your baby has been treated with phototherapy, the yellow tint to the
baby's skin and eyes may not disappear immediately. But if the yellow tint
intensifies, report it to your doctor.
It's not good to try to treat your baby's jaundice on your own by placing your baby outside in the sun, under lights in your home, or near a window in the
sunlight. Your baby's skin may get burned by the lights or the sun. Also, your baby may get too cold. Special lights and controlled
surroundings are always needed to treat jaundice safely.
mothers who breast-feed their babies are concerned that they will need to stop
breast-feeding if their babies develop jaundice. The American Academy of
Pediatrics encourages women to continue breast-feeding newborns with jaundice
who are otherwise healthy and to focus on increasing the frequency of feedings
(about 8 to 12 times every 24 hours).1 If your baby
needs help getting enough milk, you can use a lactation aid or ask your doctor
lactation consultant to help your baby latch on
If your baby is hospitalized, you may need to pump your
breasts to maintain your milk production. You can then take the milk to the
hospital for your baby's feedings.
The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.
NCBDDD aims to find the cause of and prevent birth
defects and developmental disabilities. This agency works to help people of all
ages with disabilities live to the fullest. The website has information on
many topics, including genetics, autism, ADHD, fetal alcohol spectrum
disorders, diabetes and pregnancy, blood disorders, and hearing loss.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
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sign up to get weekly emails about your area of interest.
American Academy of Pediatrics (2004). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1): 297–316. [Erratum in Pediatrics, 114(4): 1138.]
Other Works Consulted
American Academy of Pediatrics (2009). Jaundice section of Infant nutrition and development of gastrointestinal function. In RE Kleinman, ed., Pediatric Nutrition Handbook, 6th ed., pp. 47–49. Elk Grove Village, IL: American Academy of Pediatrics.
Jardine LA, Woodgate P (2011). Neonatal jaundice, search date February 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Kamath BD, et al. (2011). Jaundice. In SL Gardner et al., eds., Merenstein and Gardner's Handbook of Neonatal Intensive Care, 7th ed., pp. 531–552. St. Louis: Mosby Elsevier.
Kissoon N (2008). Jaundice. In JM Baren et al., eds., Pediatric Emergency Medicine, pp. 340–344. Philadelphia: Saunders Elsevier.
Lee HC, Madan A (2011). Hematologic abnormalities and jaundice. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 226–233. New York: McGraw-Hill.
Maheshwari A, Carlo WA (2011). Digestive system disorders. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 600–612. Philadelphia: Saunders.
May 11, 2012
John Pope, MD - Pediatrics & Chuck Norlin, MD - Pediatrics
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