Newborn Jaundice: What Every Parent Needs to Know

If your newborn's skin has a yellowish tint, you're likely dealing with jaundice—and you're far from alone. Jaundice affects about 60% of full-term babies and up to 80% of premature babies. AAP In most cases, it's harmless and resolves on its own. But understanding what to look for and when to be concerned gives you peace of mind and helps you know when to act.

What Is Jaundice?

Jaundice is the yellow coloring of a baby's skin and eyes caused by elevated bilirubin levels in the blood. Bilirubin is a yellow pigment produced when red blood cells break down—a normal process that happens continuously in our bodies. AAP

Why newborns are especially prone:

• Newborns have extra red blood cells from the womb that break down after birth
• A newborn's liver is still maturing and can't process bilirubin as efficiently as an adult's
• Breast milk can slow bilirubin elimination (this is normal and usually harmless)
• Some babies are born with conditions that increase red blood cell breakdown

In most cases, this is a temporary situation that resolves as baby's liver matures—usually within 1-2 weeks.

Types of Newborn Jaundice

Understanding the type helps predict what to expect: AAP

### Physiologic (Normal) Jaundice

• Most common type
• Appears 2-4 days after birth
• Peaks around days 3-5
• Resolves by 1-2 weeks
• Caused by normal newborn liver immaturity
• Usually requires no treatment

### Breastfeeding Jaundice

• Occurs in the first week
• Related to insufficient milk intake (not breast milk itself)
• Happens when baby isn't nursing frequently or effectively enough
• Improves with increased feeding
• May require temporary supplementation in severe cases

### Breast Milk Jaundice

• Appears after day 5-7
• Can last 2-3 weeks (sometimes longer)
• Caused by substances in breast milk that slow bilirubin processing
• Baby is otherwise healthy and feeding well
• Rarely requires treatment
• NOT a reason to stop breastfeeding

### Pathologic Jaundice

• Appears within 24 hours of birth (red flag)
• Caused by underlying medical conditions
• Blood type incompatibility (Rh or ABO)
• G6PD deficiency
• Infection
• Liver problems
• Requires prompt evaluation and treatment

How to Check for Jaundice

Here's how to assess jaundice at home: AAP

The visual check:
1. Use natural daylight (artificial light can mask yellow tones)
2. Gently press on baby's forehead or nose with your finger
3. When you release, the skin underneath should look white, then return to normal color
4. If it looks yellow before returning to normal color, jaundice may be present

Progression pattern:

• Jaundice typically starts at the head and face
• As levels rise, it spreads downward to the chest, belly, arms, and legs
• Yellow coloring in the legs suggests higher bilirubin levels than face-only yellowing

Checking different skin tones:

• Jaundice can be harder to see in babies with darker skin
• Check the whites of the eyes (sclera)
• Look at gums and the roof of the mouth
• Check palms of hands and soles of feet

When Jaundice Appears

The timing of jaundice gives important information: AAP

| When It Appears | What It Suggests |
|----------------|------------------|
| First 24 hours | Possibly pathologic—needs immediate evaluation |
| Days 2-4 | Most likely physiologic (normal) |
| After day 5 | May be breast milk jaundice or other cause |
| Persisting past 2-3 weeks | Needs medical evaluation |

Treatment Options

Most jaundice doesn't need treatment, but when it does, these are the main options: AAP

### Phototherapy ("Light Treatment")

• Baby is placed under special blue lights (or on a light blanket)
• Light helps break down bilirubin in the skin so it can be excreted
• Baby wears only a diaper and eye protection
• Usually done in the hospital, but home phototherapy units are sometimes used
• Very safe and effective

What to expect during phototherapy:

• Baby may have loose, greenish stools (from excreting bilirubin)
• Baby may be sleepier
• Frequent feeding is encouraged
• Skin-to-skin and feeding breaks are usually allowed

### Increased Feeding

For mild jaundice, simply feeding more frequently (8-12 times per day) helps by: AAP

• Improving hydration
• Stimulating bowel movements that excrete bilirubin
• Preventing breastfeeding-related jaundice from inadequate intake

### Exchange Transfusion

• Reserved for severe cases that don't respond to phototherapy
• Rarely needed
• Baby's blood is gradually replaced with donor blood
• Rapidly lowers bilirubin levels

### Supplementation

If breastfeeding is not going well and baby is dehydrated or underfed:

• Temporary formula supplementation may be recommended
• Expressed breast milk is preferred if available
• Does not mean you need to stop breastfeeding
• Often just a short-term intervention

Home Care for Mild Jaundice

If your baby's jaundice is mild and being monitored: AAP

Do:

• Feed frequently (8-12 times per day)
• Wake baby to feed if they're sleeping more than 3 hours
• Watch for adequate wet and dirty diapers
• Get plenty of natural light (indirect sunlight through a window)
• Keep follow-up appointments for bilirubin checks

Don't:

• Put baby in direct sunlight (risk of sunburn and overheating)
• Use home "bili lights" without medical supervision
• Skip feeds to let baby sleep
• Ignore signs of worsening jaundice

Warning Signs: When to Get Help

Contact your pediatrician or seek immediate care if: AAP

Jaundice concerns:

• Yellow coloring in the first 24 hours of life
• Yellow color spreading to arms, legs, or belly
• Yellow color deepening or not improving by day 7
• Whites of eyes turning yellow
• Jaundice persisting beyond 3 weeks

Feeding/behavior concerns:

• Baby is too sleepy to feed or hard to wake
• Baby isn't nursing well or refuses to feed
• Fewer than expected wet/dirty diapers
• High-pitched crying
• Baby seems very floppy or limp
• Baby is increasingly irritable

Other concerning signs:

• Fever
• Poor weight gain
• Baby seems unwell in any way

What Other Parents Ask

"Is jaundice dangerous?"
Mild jaundice is not dangerous and resolves on its own. Severe, untreated jaundice (very rare) can cause brain damage, which is why monitoring is important. The good news: with modern screening, dangerous levels are almost always caught and treated before any harm occurs. AAP

"Will jaundice affect my baby long-term?"
The vast majority of jaundice causes no lasting effects. Even babies who need phototherapy typically have no long-term consequences.

"Should I stop breastfeeding?"
No—breast milk jaundice is not harmful and is not a reason to stop nursing. Frequent breastfeeding actually helps resolve jaundice by increasing output. Only in rare, severe cases might temporary supplementation be recommended. AAP

"Does putting my baby in sunlight help?"
While natural light can help somewhat, putting baby in direct sunlight is NOT recommended due to sunburn and overheating risks. Medical phototherapy uses specific wavelengths at controlled intensity—much safer and more effective than sunlight.

"Why does my baby need blood tests?"
Bilirubin levels in the blood give a precise measurement that visual assessment can't provide. This helps your doctor know exactly whether treatment is needed and how well it's working.

Follow-Up Care

After discharge from the hospital: AAP

• Most babies should be seen by a doctor within 48-72 hours after leaving the hospital
• This is especially important for:
• Babies discharged before 72 hours of age
• Babies with jaundice at discharge
• Babies who were premature
• Babies with difficult feeding
• Your doctor may order a bilirubin check at this visit
• Additional follow-up depends on bilirubin levels and how baby is doing

The Bottom Line

Jaundice is incredibly common and usually nothing to worry about. Your job is simple: feed your baby frequently, watch for warning signs, and keep those early pediatrician appointments. Most jaundice resolves on its own within a couple of weeks, leaving behind a perfectly healthy baby.

If you're worried about what you're seeing, trust your instincts and call your pediatrician. That's exactly what they're there for—and checking is always the right call when you're concerned.

Clara is here to help you think through any jaundice questions or concerns.