Jaundice in newborns

Jaundice is a yellow color of the skin and the whites of the eyes. It comes from bilirubin, a yellow substance in the blood. The body makes bilirubin when it breaks down old red blood cells. The liver then clears it.

Before birth, the mother’s liver did this job. After birth, your baby’s liver needs a few days to take over. While it catches up, bilirubin builds up in the blood and the skin turns yellow.

Jaundice is very common in the first week. It usually shows up after the first day. It is often most visible around day 3, then slowly fades.

Some babies are more likely to get it:

• babies born a few weeks early
• babies who are not feeding well yet
• babies with bruises from birth
• babies whose blood group does not match the mother’s
• babies with a brother or sister who needed light treatment

Jaundice usually fades within 2 weeks. In breastfed babies, a light yellow color can last longer, up to a month. This is often harmless. Keep breastfeeding, and let your doctor check that all is well.

Yellow color starts on the face. As the level rises, it spreads to the chest, the belly, then the arms and legs. Look at your baby in daylight. Gently press the skin on the nose or chest, then let go. If the skin looks yellow where you pressed, tell your doctor. On darker skin, look at the whites of the eyes and the gums.

A test measures the level. Looking at the skin is not enough. Before you leave the maternity ward, the team checks every baby at least once. They use a small light device pressed on the skin, or a few drops of blood from the heel. If you go home early, your baby should be seen again within 2 days.

If the bilirubin level is too high, your baby gets light treatment. It is called phototherapy. Your baby lies under a special blue light, wearing only a diaper. Soft pads cover the eyes. The light changes bilirubin into a form the body can pass in the urine and stools.

The treatment does not hurt. It usually takes 1 to 2 days. You can still feed your baby, and feeding helps clear the bilirubin. Light treatment is usually given in hospital. In rare cases, when the level is very high, the baby needs more treatment in the neonatal unit.

Do not put your baby in the sun to treat jaundice. Sunlight does not work well and can burn your baby’s skin.

• Feed your baby often, about 8 to 12 times in 24 hours.
• If your baby is sleepy, wake them for feeds.
• Count wet and dirty diapers. Feeding helps your baby pass bilirubin in the stools.
• Keep every follow-up visit, even if your baby looks fine.

Yellow skin in the first 24 hours of life is never normal. Your baby needs a doctor right away, day or night.

Call the doctor the same day if:

• the yellow color is spreading to the belly, arms or legs
• the yellow color is getting darker
• your baby is still yellow after 2 weeks of age
• the stools are pale, white, grey or look like clay
• the urine is dark yellow or brown (newborn urine is almost clear)

Keep a pale diaper to show the doctor. Pale stools and dark urine can point to a liver problem that needs treatment early.

Call the Red Cross on 140 or go to the emergency room if your yellow baby:

• is very sleepy and hard to wake
• refuses to feed or feeds poorly
• is floppy, or very stiff with the back arched
• has a high-pitched cry that does not stop