Newborn Jaundice: Causes, Signs and Treatment
Why many newborns look yellow, and when it needs medical attention.
Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.
Jaundice, a yellow colour of the skin and the whites of the eyes, is very common in newborns, affecting roughly six in ten full-term babies and more premature babies. It is caused by a build-up of bilirubin, a yellow substance made when old red blood cells break down. A newborn's immature liver is still learning to clear it. In most babies it is harmless and goes away on its own, but high levels need treatment.
When it appears
Typical newborn jaundice shows up around days two to three of life, peaks at about days three to five and usually fades within one to two weeks. Jaundice that appears in the first 24 hours is never normal and needs urgent assessment.
How to check
- Look in natural daylight, or in a well-lit room. Gently press on your baby's forehead or nose. If the skin looks yellow when you release, your baby may have jaundice.
- Look at the whites of the eyes and the gums, and in darker skin, the palms and soles of the feet. Yellowing in darker skin can be harder to see, so check these areas.
- Jaundice starts on the face and spreads down the body, to the chest, tummy, then legs. The further down it spreads, the higher the level is likely to be.
- Visual checks are not reliable on their own. If you are worried, ask for a test.
Why some babies are more affected
- Premature babies, or babies born a few weeks early
- Babies who are not feeding well, or who are losing a lot of weight
- Bruising from the birth
- A different blood group from their mother (for example ABO or Rhesus incompatibility)
- A sibling who had jaundice that needed treatment
- Some inherited conditions, such as G6PD deficiency, which is more common in people of Mediterranean, African, Middle Eastern and Asian descent
- Infection, which is rarer
Breastfeeding and jaundice
Jaundice in the first week can be linked to a slow start to feeding, so frequent feeds matter. A different pattern, sometimes called breast milk jaundice, can last for several weeks in an otherwise healthy, thriving baby. If your baby is feeding well, gaining weight and has normal nappies, breastfeeding should usually continue. Your doctor will check that jaundice does not have another cause.
What helps
- Feed your baby frequently, at least 8 to 12 times a day if breastfed, because feeding helps clear bilirubin through stools. Wake a sleepy baby for feeds.
- Keep follow-up appointments with your midwife or doctor. Babies who are discharged early often need a check within a day or two.
- Your doctor may measure bilirubin with a skin device or a blood test, which shows whether treatment is needed.
- Do not put your baby in direct sunlight to treat jaundice. It is not a safe treatment, and sunburn is a risk.
Treatment
Most babies need no treatment. If bilirubin is high, the usual treatment is phototherapy, in which your baby lies under a special blue light, wearing only a nappy and eye protection. The light changes bilirubin so that your baby can get rid of it. It may be done in hospital, or with a light blanket at home in some places. Feeding continues, with breaks from the light for feeds and cuddles. Very rarely, a blood transfusion is needed. Treatment works well and prevents the rare, serious problems that very high bilirubin levels can cause for the brain.
Contact your doctor urgently if
- Yellowing appears in the first 24 hours after birth
- Your baby looks very yellow, or the colour spreads to the arms, legs or soles of the feet
- Your baby is very sleepy, feeding poorly, hard to wake, floppy or has a high-pitched cry
- Your baby has a fever, or arches their back
- Stools are pale, chalky or white, or urine is dark. These can be signs of a liver problem.
- Your baby has far fewer wet nappies than expected
- Jaundice lasts more than two weeks in a full-term baby, or three weeks in a premature baby
Prolonged jaundice, with pale stools and dark urine, should be checked by a doctor even if your baby seems well, because some liver conditions are best treated early, in the first weeks of life.
Looking after yourself and your baby
It is natural to worry when your baby looks yellow. Remember that jaundice is common, and most babies recover well. Feed often, rest when you can, and do not hesitate to ask for a check if you are unsure.
Where to check current advice
Thresholds for treatment and follow-up schedules vary, so follow the advice from your own health service, such as NICE and the NHS in the UK, the HSE in Ireland, the American Academy of Pediatrics in the US, the Canadian Paediatric Society in Canada and the Raising Children Network in Australia.
Trusted resources to read next
These public health resources provide additional information. Guidance can vary by country, so prioritise advice from your own care team and local health service.
- CDC: Helping babies sleep safely — Safe sleep environment recommendations for babies.
- NHS: Early days — Newborn checks, feeding, and support during the first days.
This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.