The yellow coloring is caused by bilirubin. Bilirubin is a waste product. The body makes it when red blood cells are broken down. Bilirubin normally passes out of the body through feces or urine. Jaundice happens when there is a buildup of bilirubin. This can happen when:
The baby's body does not get rid of bilirubin in the first few days of life
The baby does not get enough breastmilk because the mother's milk is not in yet or the baby is having problems feeding
A substance in breast milk blocks bilirubin from leaving the body
There is a large breakdown of red blood cells due to things like a mismatch in blood types in the mother and baby
The baby has liver problems, such as infection or liver disease
Newborn jaundice is more common in East Asian babies as well as babies who are very sick or born early. It is also more common in babies who have a sibling who was treated for jaundice. Other things that may raise the risk are:
High bilirubin levels or signs of jaundice in the first 24 hours of life
Poor feeding with breast
Baby has a different blood type than mother, resulting in hemolysis
Large bruises or bleeding under the scalp due to labor and delivery
Certain liver enzyme deficiencies
The main symptom of jaundice is yellow skin color. It often starts in the face and may spread to the stomach and legs.
All babies are checked for jaundice at birth and at 3 to 5 days of age. The doctor will ask about your baby’s symptoms and health history. A physical exam will be done. It will focus on the baby's skin.
Tests may be:
Transcutaneous bilirubin (TcB)—a light is passed through the baby's skin to screen for high bilirubin levels
Blood test—to check level of bilirubin in blood
Most babies will not need treatment. Jaundice often goes away in 2 to 3 weeks. Babies who do need treatment may need:
Increased breastfeeding can help clear bilirubin from a baby's body. Babies who are formula-fed will need to get extra formula.
Phototherapy uses special lights to change the bilirubin in the blood. The bilirubin can then pass in the urine or stool.
Babies with severe jaundice may need a blood transfusion. This will replace the baby’s blood with new blood. The excess bilirubin will be removed with the blood.
Newborn jaundice cannot always be prevented. The risk can be lowered by frequent feedings in the first several days after birth.
Neonatal hyperbilirubinemia. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/pediatrics/metabolic_electrolyte_and_toxic_disorders_in_neonates/neonatal_hyperbilirubinemia.html. Updated December 2018. Accessed January 7, 2020.
Last reviewed September 2019 by
EBSCO Medical Review Board
Kari Kassir, MD
Last Updated: 7/28/2020
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