Jaundice in Newborns: Questions and Answers

What is jaundice?
Why is jaundice common in newborns?
How can I tell if my baby is jaundiced?
Can jaundice hurt my baby?
How should my baby be checked for jaundice?
Does breastfeeding affect jaundice?
Which babies require more attention for jaundice?
When should my newborn get checked after leaving the hospital?
When should I call my baby’s doctor?
How can harmful jaundice be prevented?
When does jaundice go away?

What is jaundice?
Jaundice is the yellow color seen in the skin of many newborns. It happens when a chemical called bilirubin builds up in the baby’s blood. Jaundice can occur in babies of any race or color.

Why is jaundice common in newborns?
Everyone’s blood contains bilirubin, which is removed by the liver. Before birth, the mother’s liver does this for the baby. Most babies develop jaundice following their birth because it takes a few days for the baby’s liver to begin removing bilirubin.

How can I tell if my baby is jaundiced?
A jaundiced baby’s skin usually looks yellow. The best way to see jaundice is in daylight or under fluorescent lights. Jaundice usually appears first in the face and, as the bilirubin level increases, moves to the chest, abdomen, arms, and legs. The whites of the eyes may also be yellow. Jaundice may be harder to see in babies with darker skin color.

Can jaundice hurt my baby?
Most infants have mild, harmless jaundice. In rare situations, a high bilirubin level may cause brain damage. This is why newborns should be checked carefully for jaundice and treated to prevent a high bilirubin level.

How should my baby be checked for jaundice?
If your baby looks jaundiced in the first few days after birth, your physician or nurse may use a skin test or blood test to check your baby’s bilirubin level. A bilirubin level is always needed if jaundice develops before the baby is 24 hours old. Whether a test is needed after that depends on the baby’s age, the amount of jaundice, and whether the baby has other factors that make jaundice more likely or harder to see.

Does breastfeeding affect jaundice?
Jaundice is more common in babies who are breastfed than babies who are formula-fed. This occurs mainly in infants who are not nursing well. If you are breastfeeding, you should nurse your baby at least 8 to 12 times a day for the first few days. This will help you produce enough milk and will help to keep the baby’s bilirubin level down. If you are having trouble breastfeeding, ask your pediatrician, nurse, or lactation specialist for help. More information is available about our Lactation/ Breastfeeding Services.

Which babies require more attention for jaundice?
Some babies have a greater risk for high levels of bilirubin and may need to be seen sooner than three to four days after discharge from the hospital. Ask your doctor about an early follow-up visit if your baby has any of the following:

• A high bilirubin level before leaving the hospital.
• Early birth (more than two weeks before the due date).
• Jaundice in the first 24 hours after birth.
• Breastfeeding that is not going well.
• A lot of bruising or bleeding under the scalp related to labor and delivery.
• A parent or brother or sister who had high bilirubin and received light therapy.

When should my newborn get checked after leaving the hospital?
Your baby should be seen by a nurse or doctor between three and four days of age. This is when a bilirubin level can be at its highest. The timing of this visit may vary depending on your baby’s age when released from the hospital and other factors.

When should I call my baby’s doctor?
Call your baby’s doctor if:

• Your baby’s skin turns more yellow.
• Your baby’s abdomen, arms, or legs are yellow.
• The whites of your baby’s eyes are yellow.
• Your baby is jaundiced and is hard to wake, fussy, not nursing or taking formula well.

How can harmful jaundice be prevented?
Most jaundice requires no treatment. When treatment is necessary, placing your baby under special lights while he or she is undressed will lower the bilirubin level. Depending on your baby’s bilirubin level, this can be done in the hospital or at home. Jaundice is treated at levels that are much lower than those at which brain damage is a concern. Treatment can prevent the harmful effects of jaundice.

Putting your baby in sunlight is not recommended as a way of treating jaundice. Exposing your baby to sunlight might help lower the bilirubin level, but this will only work if the baby is completely undressed. This cannot be done safely inside your home because your baby will get cold, and newborns should never be put in direct sunlight outside because they might get sunburned.

When does jaundice go away?
In breastfed infants, jaundice often lasts from two to three weeks. In formula-fed infants, most jaundice goes away by two weeks. If your baby is jaundiced for more than three weeks, see your baby’s pediatrician.

This FAQ courtesy of the American Academy of Pediatrics