Jaundice in newborns: when it passes and when it does not

Many babies turn a little yellow in the first days. The cause is bilirubin, a yellow substance made when the body replaces red blood cells. A newborn’s liver is still learning to clear it, so bilirubin builds up for a while.

Babies usually look most yellow around day three, and the jaundice goes by itself within about 2 weeks. In breastfed babies it can last a little longer. Most cases are mild, but very high bilirubin can, rarely, damage the brain. That is why jaundice is never ignored.

How to check

• Look at your baby in natural light, near a window, not under a lamp.
• Jaundice usually starts on the face and head, then moves down to the chest, tummy and legs.
• Look at the whites of the eyes.
• Gently press the tip of the nose or the forehead. If your baby has jaundice, the skin looks yellow rather than pale when you lift your finger.
• On darker skin, check the eyes, the gums and under the tongue.

Check the nappies too. After 24 hours, wee should be pale and poo yellow or green. Dark yellow or brown wee, or pale, creamy poo, needs a doctor today. Keep a nappy or take a photo to show them.

Feeding helps

Bilirubin leaves the body in poo, so frequent feeds help: around 8 to 12 times in 24 hours. If your baby is very sleepy, wake them to feed. If breastfeeding is not going well, get help early.

Advice you will often hear

“Put them in the sun by the window.” Sunlight is not a safe treatment for jaundice. Your baby can burn or overheat, and a doctor’s check gets put off. The light hospitals use, phototherapy, is different: it is controlled light, with your baby watched, usually for about 2 days.

“Give them sugar water or tea.” Babies under 6 months need only breast milk or formula. Water and tea fill their tummy, so they drink less milk and clear bilirubin more slowly.

“Stop breastfeeding.” No. Jaundice is more common in babies who are not getting enough milk, so the answer is usually more breastfeeding, not less. Stop only if a doctor tells you to.

Tell your paediatrician if G6PD deficiency (favism) runs in the family, or if a breastfeeding mother eats broad beans, uses henna or herbal remedies, or if there are mothballs at home. Rarely, these can cause severe jaundice.

See a doctor today if

• your baby is over 24 hours old and the jaundice is not improving or is spreading
• their wee is dark yellow or brown, or their poo is pale
• the jaundice has not gone after 2 weeks

Call 127 or go to emergency care if your baby

• turns yellow in the first 24 hours of life
• is very sleepy and hard to wake
• will not feed
• is floppy, stiff or making jerking movements
• has a temperature of 38°C or higher, or 36°C or lower
• has had no wet nappies
• is struggling to breathe

Sources we consulted

• NHS: Jaundice in newborns
• AAP, HealthyChildren.org: Jaundice in newborns

Written by the mam.al editors as general information. It does not replace advice from your doctor or paediatrician. Contains public sector information licensed under the Open Government Licence v3.0.