Family Health|Infants and Toddlers
bilirubin|jaundice|light therapy|neonatal hyperbiliruminemia|yellow skin

Infant Jaundice

Last Updated October 2020 | This article was created by editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

What is infant jaundice?

Infant jaundice is common during the first few days of a baby’s life. It’s caused by high levels of bilirubin. This can make your baby’s skin, eyes, and mouth (under the tongue) turn a yellow color. While the color can look odd, infant jaundice usually isn’t serious.

Symptoms of infant jaundice

The main symptom of jaundice is a yellowing of your baby’s skin. Look for color changes in the skin, the whites of your baby’s eyes, and the pink skin inside your baby’s mouth. If your baby has pale skin, it should look white when you gently press it with your fingertips. If the skin looks yellow when you press it, your baby may have jaundice. If your baby has darker skin, it may be harder to see yellowing. But you should still be able to tell by the coloring of your baby’s eyes and under your baby’s tongue. If any of these three areas appear to be a yellowish color, call your baby’s doctor.

Infant jaundice usually appears between 2 and 7 days after birth. As the amount of bilirubin in the blood builds up, your baby’s body will get more yellow. As the bilirubin level rises, the yellow color can move from your baby’s head down to the chest and even down to the toes. These are signs that your baby may have more severe jaundice. If this happens, you should call your baby’s doctor right away.

Artificial light, especially fluorescent lights, can sometimes fool your eyes into seeing a yellow color that isn’t really there. Try to check your baby in natural daylight in a sunny room.

What causes infant jaundice?

Jaundice is caused when too much bilirubin builds up in your baby’s body. Bilirubin is a yellow substance made when the body breaks down old red blood cells. The liver filters it from the blood, and it leaves the body through the stool (poop). This is a normal process that happens all through life. However, babies sometimes get a buildup of bilirubin in their bodies. Your baby’s liver might not yet be developed enough to filter out the bilirubin. Or your baby may have a condition that increases the number of red blood cells that need to be replaced. These can cause the bilirubin to build up in your baby’s body, causing jaundice.

There are several common types of jaundice:

  • Physiological (normal) jaundice:Many newborns have this jaundice. Most of the time it isn’t severe. It doesn’t cause any problems and goes away on its own within 2 weeks.
  • Prematurity jaundice:Premature babies’ livers often aren’t developed enough to break down bilirubin effectively. They’re often treated, even if their bilirubin levels aren’t as high.
  • Breastfeeding jaundice:Babies can get this when they don’t get enough breast milk. This can happen because of difficulties with breastfeeding or because the mother’s milk hasn’t come in yet.
  • Breast milk jaundice:Sometimes substances in breast milk cause bilirubin levels to rise. They can also make it harder for the baby’s body to get rid of bilirubin through the stool. This type starts after 3 to 5 days and slowly gets better over a number of weeks.

In some cases, jaundice is caused by an underlying problem. This could include bleeding, infection, or a liver condition.

Your baby is more likely to have jaundice if he or she is:

  • Premature (born before 38 weeks):A premature baby is more likely to have an immature liver. He or she may have fewer bowel movements than a full-term baby. This means that a premature baby might not be able to remove bilirubin as quickly as a full-term baby.
  • Bruised during birth: Bruises create more red blood cells that need to be turned into bilirubin. This can raise bilirubin levels in the bloodstream.
  • Having trouble breastfeeding: Babies who have trouble breastfeeding may be dehydrated or have a low calorie intake. This can increase the risk of jaundice. Ask your doctor for help if you or your baby are having trouble breastfeeding.

How is infant jaundice diagnosed?

Your baby’s doctor will watch for signs of jaundice while you and your baby are still in the hospital. Your baby’s bilirubin levels can be checked 24 hours after birth. A probe may be used that estimates the bilirubin level just by touching the skin. If the level is high, it will be confirmed by a blood test.

If you’re at home and your baby’s skin becomes yellow, call your baby’s doctor right away. He or she will measure the amount of your baby’s bilirubin through a blood test. The doctor will probably measure your baby’s bilirubin level several times. If necessary, your baby will be treated for infant jaundice. This usually keeps the bilirubin level from getting high enough to hurt your baby.

Can infant jaundice be prevented or avoided?

In most cases, jaundice can’t be prevented. However, you can reduce the risk that your baby will develop jaundice by feeding him or her at least 8 to 12 times a day for the first several days. This will help your baby have regular bowel movements, which will remove bilirubin from his or her body.

Infant jaundice treatment

Most of the time, treatment for jaundice isn’t needed. Mild jaundice usually goes away on its own in 1 to 2 weeks.

For more serious cases of jaundice, your baby might need treatment at the hospital. Most babies who need treatment for jaundice get light therapy (also called phototherapy).

During phototherapy, your baby is placed under special lights or on a special light-producing blanket. He or she will wear only a diaper and a mask to protect his or her eyes. The light helps your baby’s body get rid of the excess bilirubin. Phototherapy usually lasts for 1 or 2 days. Sometimes, if the bilirubin levels aren’t too high, you may be able to use phototherapy at home.

In rare cases, phototherapy doesn’t work. If your baby’s bilirubin level continues to rise, your baby might need an exchange transfusion. In this treatment, some of your baby’s blood is taken out and replaced with fresh blood.

If an underlying condition is causing the jaundice, your doctor will treat the underlying condition.

Living with infant jaundice

How long jaundice lasts differs from baby to baby. Often, a baby’s bilirubin level goes up for the first 3 to 4 days and then slowly goes back down. A baby who is breastfed may have mild jaundice for a longer time than a baby who is fed formula.

Jaundice isn’t a serious problem in most healthy babies. However, very high bilirubin levels can be dangerous, and even cause brain damage. The risk of serious injury to your baby from high bilirubin levels is increased if your baby is premature. But jaundice is almost always diagnosed before the bilirubin level gets high enough to cause this kind of damage.

Questions for your doctor

  • Does my baby need treatment?
  • What treatment is best for my baby?
  • Will my baby have any problems from jaundice?
  • Will my baby need light therapy?
  • Does my baby have a severe case of jaundice?
  • Will I need to bring my baby in for follow-up appointments?
  • Will my baby need to go into the hospital?
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