Newborn jaundice

Newborn jaundice is when your baby’s skin and the white parts of his eyes look yellow. It’s caused by the build-up of a substance in the blood called bilirubin. Newborn jaundice is very common—about 3 in 5 babies (60 percent) have jaundice.

Jaundice usually happens a few days after birth. Most of the time, it’s mild, doesn’t hurt your baby and goes away without treatment. But if a baby has severe jaundice and doesn’t get quick treatment, it can lead to brain damage.

What causes jaundice in newborns?

Your baby’s body recycles some red blood cells each day. Bilirubin is a yellow substance that forms as red blood cells break down. During pregnancy, your liver removes bilirubin for your baby. After birth, your baby’s liver may not be developed enough to properly remove bilirubin on its own. It can take a few days for your baby’s liver to be able to do this.

When a baby’s liver causes jaundice in the first days of life, it’s called physiologic jaundice. This is the most common kind of jaundice in newborns. But sometimes a health condition in your baby can cause jaundice. Babies with these health conditions are more likely to need treatment to help lower their bilirubin levels than babies with physiologic jaundice. These conditions include:

  • Blood type mismatches, like Rh disease. A small number of babies have different blood types than their mothers. These mismatches can lead to a faster breakdown of red blood cells.
  • Internal bleeding. This is bleeding inside the body. 
  • A problem with your baby’s liver. Your baby’s liver may not work well if he has an infection, like hepatitis, or a disease, like cystic fibrosis, that affects the liver. 
  • A problem with your baby’s red blood cells. Some babies have too many red blood cells. This is more common in some twins and babies who are small for gestational age. This means a baby who is smaller than normal based on the number of weeks he’s been in the womb. 
  • A genetic condition, like G6PD deficiency. This condition is when your body doesn’t have enough G6PD, an enzyme that helps your red blood cells work the right way. 
  • An infection, like sepsis. This is an infection in your baby’s blood. 
  • Bruising at birth. A bruise happens when blood leaks out of a blood vessel. Sometimes babies get bruises during labor and birth. When large bruises heal, bilirubin levels may rise. 

Some babies are more likely than others to have jaundice. These include:

  • Premature babies. A premature baby is one who is born too early, before 37 weeks of pregnancy. A premature baby is more likely than others to have jaundice because his liver may not be fully developed.
  • Breastfed babies, especially babies who aren’t breastfeeding well. If you’re breastfeeding, feed your baby when he’s hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. If you’re having trouble breastfeeding, ask your baby’s provider, a nurse or a lactation consultant for help. A lactation consultant is a person with special training in helping women breastfeed. 
  • Babies with East Asian or Mediterranean ethnic backgrounds. Ethnic background means the part of the world or the ethnic group your ancestors come from. An ethnic group is a group of people, often from the same country, who share language or culture. Ancestors are family members who lived long ago, even before your grandparents. 

How do you know if your baby has jaundice?

When a baby has jaundice, a yellowish color usually first appears on his face. It then may spread to his chest, belly, arms, legs and white parts of his eyes. The best way to see jaundice is in good light, like in daylight or under fluorescent lights. Jaundice can be harder to see in babies with darker skin.

Call your baby’s health care provider right away if your baby:

  • Looks very yellow, orange or greenish-yellow
  • Is hard to wake up or won’t sleep at all
  • Has trouble breastfeeding or sucking from a bottle
  • Is very fussy
  • Has too few wet or dirty diapers 

Call 911 or take your baby to the hospital if he:

  • Won’t stop crying or has a high-pitched cry
  • Arches backward
  • Has a stiff, limp or floppy body
  • Has strange eye movements 

These may be warning signs of dangerously high levels of bilirubin that need quick treatment to prevent kernicterus. This is a kind of brain damage caused by high bilirubin levels. Kernicterus isn’t common because babies usually are treated before jaundice becomes severe. If untreated, kernicterus can cause:

  • Athetoid cerebral palsy. Babies with this condition have uncontrollable movements in the arms, legs, face and other body parts.
  • Hearing loss
  • Vision problems
  • Dental problems 
  • Intellectual disabilities 

How are babies checked for jaundice?

The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice after birth while in the hospital. Your baby’s provider checks her with one or more of these tests:

  • Blood test. This is the best way to measure bilirubin levels. Your baby’s provider takes a small sample of blood from her heel to do this test.
  • Physical exam. Your baby’s provider checks your baby’s body for signs of jaundice. 
  • Skin test. Your baby’s provider places a device on your baby’s forehead to check her bilirubin level. The device measures the reflection of a special light that shines through her skin.

The AAP recommends that babies be checked for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest. If your baby leaves the hospital before 72 hours (3 days) of age, she should be checked within the next 2 days.

How is jaundice treated?

Most babies with jaundice don’t need treatment. If your baby has mild jaundice, her provider may recommend that you breastfeed your baby more often so that she has more bowel movements. This helps to get rid of bilirubin.

Jaundice usually clears up within 2 weeks in formula-fed babies. It may last for more than 2 to 3 weeks in breastfed babies. If your baby’s jaundice lasts more than 3 weeks, talk to his health care provider.

If your baby has more severe jaundice, she may need treatment including:

  • Phototherapy treatment (also called light therapy or bili lights). This is when your baby is placed under special lights that help her body change bilirubin into a form that she can get rid of in her urine. While she is under the lights, your baby wears just a diaper and shields over her eyes. Some babies can lie on a light therapy blanket (also called a fiber optic blanket) that has tiny bright lights in it. You may use the blanket in place of, or along with, the overhead lights. Phototherapy can be done in the hospital or at home, and it’s safe for your baby.
  • Exchange transfusion. If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, she may need a special type of blood transfusion called an exchange transfusion. An exchange transfusion gets rid of bilirubin by replacing your baby’s blood with fresh blood in small amounts.
  • Intravenous immunoglobulin (also called IVIg). If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. This can help her treat her jaundice so that she’s less likely to need an exchange transfusion.


See also:
Premature babies


Last reviewed: April, 2013

Newborn jaundice is when your baby’s skin and the white parts of his eyes look yellow. It’s caused by the build-up of a substance in the blood called bilirubin. Newborn jaundice is very common—about 3 in 5 babies (60 percent) have jaundice.

Jaundice usually happens a few days after birth. Most of the time, it’s mild, doesn’t hurt your baby and goes away without treatment. But if a baby has severe jaundice and doesn’t get quick treatment, it can lead to brain damage.

What causes jaundice in newborns?

Your baby’s body recycles some red blood cells each day. Bilirubin is a yellow substance that forms as red blood cells break down. During pregnancy, your liver removes bilirubin for your baby. After birth, your baby’s liver may not be developed enough to properly remove bilirubin on its own. It can take a few days for your baby’s liver to be able to do this.

When a baby’s liver causes jaundice in the first days of life, it’s called physiologic jaundice. This is the most common kind of jaundice in newborns. But sometimes a health condition in your baby can cause jaundice. Babies with these health conditions are more likely to need treatment to help lower their bilirubin levels than babies with physiologic jaundice. These conditions include:

  • Blood type mismatches, like Rh disease. A small number of babies have different blood types than their mothers. These mismatches can lead to a faster breakdown of red blood cells.
  • Internal bleeding. This is bleeding inside the body. 
  • A problem with your baby’s liver. Your baby’s liver may not work well if he has an infection, like hepatitis, or a disease, like cystic fibrosis, that affects the liver. 
  • A problem with your baby’s red blood cells. Some babies have too many red blood cells. This is more common in some twins and babies who are small for gestational age. This means a baby who is smaller than normal based on the number of weeks he’s been in the womb. 
  • A genetic condition, like G6PD deficiency. This condition is when your body doesn’t have enough G6PD, an enzyme that helps your red blood cells work the right way. 
  • An infection, like sepsis. This is an infection in your baby’s blood. 
  • Bruising at birth. A bruise happens when blood leaks out of a blood vessel. Sometimes babies get bruises during labor and birth. When large bruises heal, bilirubin levels may rise. 

Some babies are more likely than others to have jaundice. These include:

  • Premature babies. A premature baby is one who is born too early, before 37 weeks of pregnancy. A premature baby is more likely than others to have jaundice because his liver may not be fully developed.
  • Breastfed babies, especially babies who aren’t breastfeeding well. If you’re breastfeeding, feed your baby when he’s hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. If you’re having trouble breastfeeding, ask your baby’s provider, a nurse or a lactation consultant for help. A lactation consultant is a person with special training in helping women breastfeed. 
  • Babies with East Asian or Mediterranean ethnic backgrounds. Ethnic background means the part of the world or the ethnic group your ancestors come from. An ethnic group is a group of people, often from the same country, who share language or culture. Ancestors are family members who lived long ago, even before your grandparents. 

How do you know if your baby has jaundice?

When a baby has jaundice, a yellowish color usually first appears on his face. It then may spread to his chest, belly, arms, legs and white parts of his eyes. The best way to see jaundice is in good light, like in daylight or under fluorescent lights. Jaundice can be harder to see in babies with darker skin.

Call your baby’s health care provider right away if your baby:

  • Looks very yellow, orange or greenish-yellow
  • Is hard to wake up or won’t sleep at all
  • Has trouble breastfeeding or sucking from a bottle
  • Is very fussy
  • Has too few wet or dirty diapers 

Call 911 or take your baby to the hospital if he:

  • Won’t stop crying or has a high-pitched cry
  • Arches backward
  • Has a stiff, limp or floppy body
  • Has strange eye movements 

These may be warning signs of dangerously high levels of bilirubin that need quick treatment to prevent kernicterus. This is a kind of brain damage caused by high bilirubin levels. Kernicterus isn’t common because babies usually are treated before jaundice becomes severe. If untreated, kernicterus can cause:

  • Athetoid cerebral palsy. Babies with this condition have uncontrollable movements in the arms, legs, face and other body parts.
  • Hearing loss
  • Vision problems
  • Dental problems 
  • Intellectual disabilities 

How are babies checked for jaundice?

The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice after birth while in the hospital. Your baby’s provider checks her with one or more of these tests:

  • Blood test. This is the best way to measure bilirubin levels. Your baby’s provider takes a small sample of blood from her heel to do this test.
  • Physical exam. Your baby’s provider checks your baby’s body for signs of jaundice. 
  • Skin test. Your baby’s provider places a device on your baby’s forehead to check her bilirubin level. The device measures the reflection of a special light that shines through her skin.

The AAP recommends that babies be checked for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest. If your baby leaves the hospital before 72 hours (3 days) of age, she should be checked within the next 2 days.

How is jaundice treated?

Most babies with jaundice don’t need treatment. If your baby has mild jaundice, her provider may recommend that you breastfeed your baby more often so that she has more bowel movements. This helps to get rid of bilirubin.

Jaundice usually clears up within 2 weeks in formula-fed babies. It may last for more than 2 to 3 weeks in breastfed babies. If your baby’s jaundice lasts more than 3 weeks, talk to his health care provider.

If your baby has more severe jaundice, she may need treatment including:

  • Phototherapy treatment (also called light therapy or bili lights). This is when your baby is placed under special lights that help her body change bilirubin into a form that she can get rid of in her urine. While she is under the lights, your baby wears just a diaper and shields over her eyes. Some babies can lie on a light therapy blanket (also called a fiber optic blanket) that has tiny bright lights in it. You may use the blanket in place of, or along with, the overhead lights. Phototherapy can be done in the hospital or at home, and it’s safe for your baby.
  • Exchange transfusion. If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, she may need a special type of blood transfusion called an exchange transfusion. An exchange transfusion gets rid of bilirubin by replacing your baby’s blood with fresh blood in small amounts.
  • Intravenous immunoglobulin (also called IVIg). If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. This can help her treat her jaundice so that she’s less likely to need an exchange transfusion.


See also:
Premature babies


Last reviewed: April, 2013