Everything You Need to Know About Jaundice in Newborns and Babies

After all the time and planning, your newborn is finally here! It’s such an exciting time, and there’s so much going on. One thing you might notice a day or two after birth is that your newborn baby’s face is starting to turn a little yellow. If you do see this, your little one may have jaundice.

Read on to learn more about what jaundice is, what the causes and symptoms are, how jaundice is diagnosed and treated, and what the complications of severe jaundice might be.

What Is Jaundice?

Many otherwise healthy newborn babies get jaundice. Here’s how it happens: The normal breakdown of red blood cells in the bloodstream produces a yellow substance called bilirubin. If your baby’s liver isn’t yet able to fully remove bilirubin from the bloodstream, a buildup of this substance occurs. This buildup, called hyperbilirubinemia, is what causes jaundice, which is when your baby’s skin and perhaps the white parts of their eyes turn a yellowish color.

Signs and Symptoms of Jaundice

With jaundice, a yellowish color will typically appear on your baby’s face first, possibly spreading to the chest and tummy, beginning to appear on the arms, legs, and in the whites of your baby’s eyes.

Let your baby’s healthcare provider know if you notice any of these signs.

Signs That Jaundice May Be Getting Worse

In most cases, jaundice will go away on its own after a few weeks, but if you notice any of the following symptoms, your baby needs medical attention right away:

• Your baby’s skin becomes more yellow

• Your baby is abnormally drowsy or sluggish

• It’s difficult to wake your baby from sleep

• Your baby has a high-pitched cry

• Your baby is sucking or feeding poorly

• Your baby has a fever

• Your baby is arching their neck and body backward.

What Causes Jaundice in Newborns and Babies?

These are some of the factors that may increase your baby’s chance of getting jaundice:

1. You’re breastfeeding your baby, and they're not nursing about 8 to 12 times per day. (Learn how you might increase your breast milk supply.)

2. Your baby was born prematurely. Preemies are more likely to get jaundice than full-term babies because they may be less able to efficiently remove bilirubin from the bloodstream.

3. You and your baby have what's called ABO incompatibility. ABO incompatibility is when your blood type and your baby’s blood type are different and noncompatible.

4. Your baby was delivered via vacuum extraction. The bruising that may happen on your baby’s head during the procedure could lead to a higher concentration of bilirubin, which leads to jaundice. Your healthcare provider may opt for a vacuum extraction during a vaginal delivery if they decide you need assistance delivering your baby. Injuries that may happen during a vacuum extraction generally have no lasting effects on your baby.

5. Your baby has certain genetic issues that make red blood cells fragile, which means they break down more easily and, therefore, increase bilirubin levels. Your healthcare provider can determine if your baby is at risk of having these particular kinds of genetic issues.

6. Your baby develops sepsis, a severe response to an infection.

7. Your baby has internal bleeding of any kind.

8. You, the one who gave birth, have cytomegalovirus (CMV), which is a common virus occurring in 50 to 80 percent of women in the U.S. by the time they turn 40. CMV doesn’t usually cause symptoms, but if it does, they’re usually fatigue, a sore throat, and fever. If you’re a healthcare worker or work with children, you’re more likely to get CMV, so let your healthcare provider know if you do. In any case, talk to your provider if you’d like to be tested.

9. Your Rh factor, which is a protein found on the surface of red blood cells, is negative, and your baby’s is positive.

10. You had gestational diabetes during your pregnancy. Your provider will offer screening tests for this form of diabetes during your pregnancy.

When Does Jaundice Usually Occur in Babies?

A majority of healthy newborns have physiological jaundice, which is also called “normal” jaundice. This “normal” jaundice usually appears about two to four days after birth. It typically doesn’t require special treatment and goes away on its own within two or three weeks.

If jaundice occurs before the second day or after the fourth day of birth, it may be caused by something more serious than physiological or “normal” jaundice such as a genetic disorder, an infection, or one of the other causes of jaundice listed above.

Diagnosis

Your baby should be checked for jaundice by their healthcare provider between three and five days after birth, as this is when bilirubin levels are usually highest.

Your baby’s healthcare provider will do an initial evaluation based on the amount of yellow in the skin as well as your baby’s age and other factors.

If the provider determines that jaundice may be present, to more accurately diagnose the condition, your baby may be tested for jaundice with

• a blood test

• a skin test (A transcutaneous bilirubinometer device is used, which measures the reflection of a special light that it shines through your baby’s skin.)

• a physical exam.

There are some cases when your baby may need to be checked sooner than three to five days after birth. These include:

• had jaundice within the first 24 hours after they were born

• had high bilirubin levels before they left the hospital. (It’s the policy of most hospitals to examine your baby for signs of jaundice before your little one is released to go home.)

• was born more than two weeks before their due date

• isn’t breastfeeding about 8 to 12 times per day

• has a lot of bruises or bleeding under the scalp—usually the result of a difficult delivery

• has a parent, sibling, or other family member who had high bilirubin levels and had to be treated for it.

Jaundice Treatment

If your baby’s healthcare provider determines that your baby needs treatment for jaundice, they may prescribe one of the following treatments, depending upon the severity of the jaundice:

• Light therapy. Also called phototherapy, this treatment reduces bilirubin levels by putting your baby under special lights. This phototherapy treatment is done either at the hospital or at your home if you have the special kind of lighting needed. Your baby will need to be undressed under the lights and will need to wear a special eye covering to protect their eyes.

• Intravenous immunoglobulin (IVIg). If your baby’s jaundice is related to blood type differences between you and your baby, for example, in the case of ABO Incompatibility , then an intravenous transfusion of a blood protein that helps slow the breakdown of red blood cells in your baby may help end jaundice.

• Exchange transfusion. In rare instances when other treatments aren't effective, an exchange transfusion treatment is done to reduce jaundice. In this treatment, specified amounts of blood are taken from your baby and replaced with donor blood so the bilirubin levels in your baby’s blood are diluted. This procedure is done in a newborn intensive care unit (NICU) at the hospital. If your baby needs to be cared for in the NICU, you can expect specialized and expert care.

How Long Does Jaundice Typically Last?

It’s best to ask your healthcare provider when things are likely to return to normal, as the length of time your baby has jaundice can be affected by what caused jaundice in the first place and what treatment your baby’s getting.

In cases of physiological (“normal”) newborn jaundice, if you’re breastfeeding your baby, it will usually go away within two or three weeks without special treatment.

If you’re formula feeding, “normal” newborn jaundice will likely only last until your baby is about 2 weeks old, since formula—unlike breast milk—doesn’t slow the liver’s capability of removing bilirubin from the bloodstream. .

Talk to your baby’s healthcare provider if your baby has been diagnosed with “normal” jaundice, yet it seems to last for more than three weeks.

Potential Complications Associated With Jaundice

In some cases, if left untreated, high levels of bilirubin can affect the brain and result in serious complications. Prompt treatment is the best way to protect against complications like kernicterus, which is a form of brain damage. Kernicterus can result in vision problems, learning problems, dental problems, or movement disorders.

Don’t worry—kernicterus is rare. Babies are usually treated well before jaundice becomes this severe. Keep your baby’s healthcare provider informed about any symptoms your baby might have, and they will be able to take steps to help ensure severe complications are avoided.

The Bottom Line

Jaundice is very common in newborn babies, and most often, it’s the kind that will clear on its own within a few weeks. Keep an eye on your baby and let their healthcare provider know if you see any signs of jaundice getting worse or persisting beyond a couple of weeks.

Remember that quick diagnosis and treatment can help ensure that any jaundice is well managed, and doesn’t cause any problems for your baby. Soon things will settle down, and you can enjoy this newborn phase.

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_{How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.}