Published - February 21 Last Updated: February 21, 2026
On day 3, my daughter looked like she'd been
spray-tanned orange. Her eyes had a yellow tinge. I called the pediatrician,
who said, "Bring her in now." Her bilirubin was 17—high enough for
phototherapy. We spent two days with her under bili lights, wearing tiny eye
shields, looking like she was at a tanning salon. Here's everything I learned
about newborn jaundice, what's normal, what's dangerous, and why it
usually resolves without any lasting effects.
Jaundice is one common newborn condition—explore our complete newborn health guide for
all health topics.
What Is Newborn Jaundice?
Definition (Yellow Skin and Eyes)
Newborn jaundice makes your baby's skin and the
whites of their eyes look yellow. It happens when a substance called bilirubin
builds up in the blood. Bilirubin is a yellow pigment that comes from breaking
down red blood cells.
How Common It Is
Jaundice is very common. Jaundice
develops in roughly six out of ten full-term newborns and in about eight out of
ten preterm infants. Most cases are mild and harmless.
Why Babies Get Jaundice
Babies are born with extra red blood cells. As these
cells break down naturally, they create bilirubin. A newborn's liver isn't
mature enough to process all this bilirubin quickly, so it builds up in the
blood and makes the skin look yellow.
Bilirubin Explained
Bilirubin is a yellow substance made when old red blood
cells break down. Normally, the liver processes bilirubin and removes it from
the body through poop. In newborns, the liver is still learning to do this job
efficiently.
Types of Newborn Jaundice
Physiological Jaundice (Normal, Most Common)
This is the most common type of newborn jaundice.
It's completely normal and happens because the baby's liver is still immature.
Timeline
- Appears - Day 2-3 after birth
- Peaks - Day 3-5
- Resolves - Within 2 weeks
This type rarely needs treatment, just
monitoring.
Pathologic Jaundice (Abnormal)
This type is not normal and needs immediate medical
attention.
Warning signs -
- Appears within 24 hours
of birth (always urgent)
- Rises rapidly (gets much worse in
hours)
- Requires investigation
to find the cause
Pathologic jaundice can signal blood type problems,
infection, or other serious issues.
Breastfeeding Jaundice
This happens in the first week when the baby
isn't getting enough breast milk.
Causes - Inadequate milk intake means less bilirubin leaves the body through poop.
Solution - Feed more frequently—every 2-3 hours.
Improves with - Better feeding, sometimes
formula supplementation
Establishing good milk intake
prevents breastfeeding jaundice from inadequate feeding.
Breast Milk Jaundice
This appears after the first week and differs from breastfeeding jaundice.
Causes - A substance in breast milk that makes bilirubin hang around for longer.
Duration - Can last weeks to months.
Important - Baby is healthy and growing well otherwise.
Treatment - Usually just
monitoring—no need to stop breastfeeding
Causes of Newborn Jaundice
Normal Breakdown of Red Blood Cells
All babies are born with extra red blood cells. As
these breakdown in the first days and weeks, they create bilirubin. This is
completely normal.
Immature Liver Function
A newborn's liver is still learning its job. It can't
process bilirubin as fast as an older child's or an adult's liver can. This is why
jaundice is so common in newborns.
Blood Type Incompatibility (ABO, Rh)
If mom and baby have different blood types (like mom is
O and baby is A or B), or different Rh factors, baby's red blood cells may
break down faster than normal. This creates more bilirubin.
Bruising from Birth
Birth can cause bruising, especially with vacuum or
forceps delivery. As bruises heal, they release extra bilirubin into the baby's
system.
Prematurity
Premature babies' livers are even less mature than those
of full-term babies. They're at higher risk for jaundice and may need treatment
at lower bilirubin levels.
Inadequate Feeding
Not eating enough means less bilirubin leaves through
poop. Excessive weight loss and jaundice are connected to dehydration
and worsen both conditions. Adequate feeding and output (6+ wet diapers)
help eliminate bilirubin and prevent worsening jaundice.
Other Medical Causes
Less common causes include infection, liver problems,
metabolic disorders, and genetic conditions affecting red blood cells (like
G6PD deficiency).
Recognizing Newborn Jaundice
Visual Assessment
The best way to check is to look at the baby in natural
daylight—not artificial light, which can hide yellowing.
Yellowing Pattern (Head to Toe)
Jaundice follows a pattern:
1.
Face
yellows first
2.
Chest next
3.
Belly after
that
4.
Legs
and feet last
The further down the body goes, the higher the
bilirubin level usually is.
Checking in Natural Light
Go to a window in daylight. Artificial light,
especially fluorescent light, makes it hard to see jaundice. Natural light
shows true skin colour.
Pressing Skin Gently
Press gently on the baby's forehead or chest with your
finger. When you lift your finger, look at that spot. If it looks yellow
instead of pink or normal skin colour, that's jaundice.
Distinguishing jaundice from other normal skin colour
changes in newborns.
When to Notice (Day 2-3 Usually)
Most babies develop visible jaundice on day 2-3 of
life. If you notice yellow skin or eyes within the first 24 hours, call your
doctor immediately; that's never normal.
Bilirubin Testing
Transcutaneous (Skin Device)
A small handheld device can measure bilirubin through
the skin. The doctor or nurse places it on the baby's forehead. It's quick,
painless, and gives an estimate.
Blood Test (Total Serum Bilirubin)
A blood test gives the exact bilirubin level. This is
done if the skin test shows high levels or if the baby needs precise monitoring.
Learn about bilirubin testing procedures including blood draws and
transcutaneous measurement.
What the Numbers Mean
Bilirubin is measured in mg/dL (milligrams per
deciliter). What's considered high depends on:
- Baby's age in hours
- Whether the baby was full-term or premature
- Other risk factors
There's no single "normal" number; it's based
on charts that account for these factors.
Risk Zones and Charts
Doctors use Bhutani charts that show low-risk,
intermediate-risk, and high-risk zones based on the baby's age in hours and
bilirubin level.
When Repeated Tests Needed
If bilirubin is rising, the baby needs repeated tests
(usually every 4-12 hours) to make sure it's not climbing too high. Tests
continue until levels start coming down.
When Newborn Jaundice Is Dangerous
Kernicterus Explained (Brain Damage)
Kernicterus is rare but serious brain damage from very
high bilirubin levels. With proper monitoring and treatment, this rarely
happens. But it's why doctors take high bilirubin seriously.
Warning Signs
Call your doctor immediately if:
- Jaundice within 24 hours
of birth (always urgent)
- Rapid increase (much more yellow in
just hours)
- Very high bilirubin levels
(the doctor will tell you the number)
- Baby won't wake to feed
(extreme sleepiness)
- High-pitched cry (sounds different
from normal)
- Arching back with a stiff body
- The yellow colour reaches the legs and feet
Know when to call about yellow skin—jaundice
within 24 hours is always urgent.
Risk Factors for Severe Jaundice
Higher risk babies include:
- Premature babies
- Babies with blood type incompatibility
- Babies with bruises from birth
- East Asia or Mediterranean descent
- Family history of jaundice
- Babies do not feed well
Bilirubin screening at birth helps
identify babies at risk before hospital discharge.
Treatment Options for Newborn Jaundice
Phototherapy (Bili Lights)
How it works - Special blue lights break down
bilirubin in the baby's skin so the body can eliminate it more easily.
What to expect - Baby lies under lights wearing only a
diaper and eye shields (to protect eyes). Can be done in a hospital or
sometimes at home.
Duration - Usually 1-3 days, depending on how
quickly bilirubin comes down.
Side effects - Loose stools (good—helps eliminate
bilirubin), mild dehydration (needs extra feeding), temporary skin rash,
temperature changes.
Phototherapy is safe, effective, and the most common
treatment for newborn jaundice.
Increased Feeding
More frequent nursing or bottles - Feed
every 2-3 hours, or 8-12 times daily.
Why it helps - More feeding means more poop, which
is how bilirubin leaves the body. Monitoring stool and urine output
ensures the baby is eliminating bilirubin effectively.
Exchange Transfusion (Rare, Severe Cases)
In very rare, severe cases, babies may need a blood
transfusion where the baby's blood is gradually replaced with donor blood. This
removes bilirubin quickly. This is only for extreme situations.
Treating Underlying Causes
If jaundice is caused by infection, blood type
problems, or other medical issues, doctors treat the underlying cause along
with managing the bilirubin level.
Breastfeeding and Newborn Jaundice
Breastfeeding Jaundice (First Week)
This happens when the baby isn't getting enough breast
milk in the first week.
Caused by - Not enough milk intake.
Solution - Feed more frequently—every 2-3 hours, wake the baby to feed. Sometimes
needed - Temporary formula supplementation to increase intake. Never
stop - Don't stop breastfeeding—feed MORE.
Breast Milk Jaundice (After First Week)
This appears after the first week and is completely
different.
Caused by - A harmless substance in breast milk that affects how the baby processes bilirubin.
Duration - Can last several weeks to months.
Baby's health - Baby is healthy, gaining weight,
and developing normally. Treatment - Monitor bilirubin levels, but no
need to stop breastfeeding. Important - This is harmless and doesn't hurt
the baby.
Home Care for Mild Newborn Jaundice
Feeding Frequency (8-12 Times Daily)
Feed the baby frequently—every 2-3 hours. More feeding
means more elimination of bilirubin through poop. Wake a sleepy baby to feed.
Monitoring Diaper Output
Count diapers: Baby should have at least 6 wet diapers
and 3-4 poopy diapers daily by day 4-5. More poop means more bilirubin leaving
the body.
Sunlight Exposure (Limited, Supervised)
Brief indirect sunlight (not direct sun) can help a
tiny bit, but:
- Never put a baby in direct sunlight
- Never leave a baby by a window unsupervised
- This is NOT a substitute for medical treatment
- Only for very mild jaundice with the doctor's approval
When Home Care Isn't Enough
If jaundice worsens despite feeding, babies seem
very yellow, or bilirubin levels keep rising, medical treatment is needed.
Don't rely on home care alone without doctor monitoring.
Follow-up and Monitoring
When to See a Doctor
The jaundice check at the first visit (3-5 days
after birth) is critical for catching rising bilirubin. All babies should be
seen within days after hospital discharge, especially if showing any yellowing.
Repeat Bilirubin Checks
If the baby has jaundice, the doctor will check
bilirubin levels regularly—sometimes daily—until they're coming down. This
ensures the baby stays safe.
Long-Term Outlook
With proper monitoring and treatment, almost all babies
with judo do perfectly fine. The jaundice resolves, and there are no lasting
effects.
No Lasting Effects (When treated)
When newborn jaundice is monitored and treated
appropriately, babies have no long-term effects. The liver matures, bilirubin
normalizes, and the baby is completely healthy.
Prevention Strategies
Early and Frequent Feeding
Start feeding within the first hour after birth. Feed
frequently—every 2-3 hours. This helps the baby's body eliminate bilirubin
before it builds up.
Monitoring High-Risk Babies
Babies at higher risk (premature, blood type
incompatibility, bruising, family history) need closer monitoring with more
frequent bilirubin checks.
Pre-Discharge Bilirubin Check
All babies should have bilirubin checked before leaving
the hospital. This identifies babies whose levels are rising so they can be
monitored closely.
Post-discharge follow-up
See your pediatrician within 3-5 days after hospital
discharge. This timing catches jaundice that peaks around 3-5 days.
Frequently Asked Questions
How do I know if my baby has jaundice?
Yellowing skin and whites of eyes, starting on the face
and moving downward. Check in natural daylight—press skin gently, look for
yellow colour underneath. If the skin or eyes look yellow, call a pediatrician
for a bilirubin check.
Is jaundice dangerous?
Mild jaundice is common and harmless. Severe
untreated jaundice can cause kernicterus (brain damage), but this is rare with
proper monitoring. Any jaundice within the first 24 hours, rapid increase, or a
very yellow baby needs immediate medical attention.
Will I stop breastfeeding?
Rarely. Breastfeeding jaundice (first week) means
feed MORE frequently, do not stop. Breast milk jaundice (after week 1) is
harmless—continue nursing while monitoring levels. Very rarely, a doctor may
suggest temporary formula supplementation to boost intake.
What is photo therapy, and does it hurt?
Phototherapy uses special blue lights that break
down bilirubin in the baby's skin. Baby lies under lights wearing only a diaper
and eye protection. It doesn’t hurt, but it can cause loose stools, mild
dehydration, and temperature changes. Most effective treatment.
How long does jaundice last?
Physiologic jaundice typically resolves within 1-2
weeks. Breast milk jaundice can last several weeks to months, but it is harmless. The
pathologic jaundice timeline depends on the cause and treatment.
Conclusion
Newborn jaundice can feel terrifying when your baby suddenly looks more yellow than usual. But here's the reassurance most parents need - with proper monitoring, it's almost always manageable and leaves no lasting effects. Trust your instincts — if your baby looks yellow, especially within the first 24 hours, call your doctor without hesitation.
Feed
frequently, watch for warning signs, and lean on your pediatrician for
guidance. The bili lights and tiny eye shields are temporary. A healthy,
thriving baby is the outcome.
Worried about your newborn's health? Learn all the warning signs that need immediate medical attention.
Medical Disclaimer: This article provides general
information and is not a substitute for professional medical advice. Discuss
jaundice concerns with your pediatrician.
Reference
1.
American
Academy of Pediatrics - https://www.healthychildren.org/English/ages-stages/baby/Pages/Jaundice.aspx
2.
CDC
Newborn Screening - https://www.cdc.gov/newborn-screening/index.html
3.
Cleveland
Clinic - https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns/
