What is jaundice and why is it common in newborns?
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.
Everyone’s blood contains bilirubin, which comes from red blood cells and is removed by the liver. Before birth, the mother’s liver does this for the baby. Most babies develop jaundice in the first few days after birth because it takes a few days for the baby’s liver to get better at removing bilirubin.
How can I tell if my newborn is jaundiced?
- Jaundice starts on the face and moves downward. Try to determine where it stops.
- View your baby unclothed in natural light near a window.
- Press on the skin with a finger to remove the normal skin tone.
- Then try to look if the skin is yellow before the pink color returns.
- Move down the body, doing the same. Try to look where the yellow color stops.
- Jaundice that only involves the face is always harmless. As it involves the chest, the level is going up. If it involves the stomach, arms or legs, the bilirubin needs to be checked. It also needs to be checked if the white of the eyes (sclera) turns yellow.
What causes jaundice?
50% of newborns have jaundice that is "physiological," meaning normal.
- Onset 2 to 3 days of age
- Peaks day 4 to 5, then improves
- Disappears 1 to 2 weeks of age
- Due to inadequate intake of breastmilk
- Pattern similar to physiological type
- Also, causes poor weight gain
- Goes away when baby gets enough milk
10% of newborns have jaundice due to breastmilk
- Due to substance in breastmilk which blocks removal of bilirubin
- Onset 4 to 7 days of age
- Lasts 3 to 12 weeks
- Not harmful
Some babies have jaundice due to blood group mismatch
- Onset during first 24 hours of life
- Can reach harmful levels
What should I do if my baby has jaundice?
If you feed your baby with a bottle, increase how often you feed them.
- Try to feed every 2 to 3 hours during the day.
- Don’t let your baby sleep more than 4 hours at night without a feeding.
If you breastfeed, increase how often you feed your baby.
- Nurse your baby every 1½ to 2 hours during the day.
- Don’t let your baby sleep more than 4 hours at night without a feeding.
- Goal: At least 10 feedings every 24 hours.
Infrequent stools means your baby needs more milk:
- Breastmilk and formula help carry bilirubin out of the body. Therefore, good feedings are important for bringing down the bilirubin level.
- In the first weeks, keep track of how many stools are passed daily. The number of stools reflects how much milk your baby is getting.
- If your baby is 5 days or older, he should have at least 3 stools daily. If stooling less than that, it usually means your baby needs more to eat.
- Try to increase the number and amount of feedings per day.
- If you are having any trouble with breastfeeding, consult a lactation expert. Also, schedule a weight check.
Contact your healthcare team if:
- Jaundice gets worse
- Belly or legs turn yellow
- Feeds poorly or has a weak suck
- Your baby starts to look or act abnormal
- Jaundice lasts more than 14 days
- You think your baby needs to be seen
Adapted from AAP Pediatric Education materials.
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