Newborn Jaundice: What It Is and How to Support Your Baby

Newborn Jaundice: What It Is and How to Manage It

If you’ve heard other parents mention jaundice in their newborns, it may have sounded worrying. It’s completely normal to feel anxious when something doesn’t seem quite right with your baby. But the good news is that newborn jaundice is very common, often harmless, and usually resolves with little or no treatment.

Here’s what you need to know to feel more confident and informed if your baby develops jaundice.

What Is Jaundice in Newborns?

First things first - this is not a liver disease.

Jaundice is caused by a temporary build-up of a substance called bilirubin, which forms when the body breaks down old red blood cells. Normally, the liver helps remove bilirubin, but in newborn babies, the liver is still maturing and doesn’t always process it quickly enough. This results in a yellowing of the skin and eyes, known as physiological jaundice.

How Common Is It?

Jaundice affects:

• Around 60% of full-term babies
• Around 80% of babies born before 38 weeks

So as you can see, it’s incredibly common. Most cases are mild, fade on their own, and don’t cause long-term issues. Only about 5% of babies with jaundice will need treatment in hospital.

What Does Jaundice Look Like?

Jaundice usually appears first in the face, then gradually moves down the body to the chest, tummy, and legs. The whites of the eyes may also look yellow. This colour change typically peaks around day 6 (remember, the day your baby is born is day 0), and then gradually fades in reverse order - the legs loose the yellow tinge first, then the tummy, chest and finally the face.

Jaundice usually clears by 2 weeks of age.

If your baby is very sleepy, hard to wake, or not feeding well, always seek medical advice. These are common behaviours in newborns, but combined with jaundice, they may need closer monitoring.

How Is Jaundice Checked?

Your midwife will check your baby for signs of jaundice during postnatal visits. This is usually done:

• In natural daylight, as indoor lighting can make skin tones appear more yellow
• By gently pressing on your baby’s chest or forehead to see whether the skin looks yellow under slight pressure

If jaundice is suspected, your midwife will use a small handheld device called a bilirubinometer. This shines a light on your baby’s skin and gives an estimated bilirubin level. If the reading is high, your baby may be referred to a clinic for a blood test to measure the exact level.

It’s important to note that visual assessment of jaundice can be more difficult in babies with darker skin tones. That’s why using a bilirubinometer is especially important in these cases.

What Is the Treatment?

In most cases, no treatment is needed beyond regular feeding and keeping your baby hydrated and well-rested. Feeding helps your baby pass the bilirubin through their system.

If the bilirubin levels are higher than normal, your baby may need phototherapy in hospital. This treatment helps the body break down bilirubin more quickly. Only a small percentage of babies need this.

Very rarely, if a baby doesn’t respond to phototherapy, they may need a blood transfusion. This is uncommon, and your healthcare team will explain everything clearly and answer any questions to reassure you if this is required.

What Is Phototherapy?

Phototherapy uses a special blue light to help your baby’s body change bilirubin into a form that can be passed out through their urine. It’s a very effective treatment and is monitored closely by the medical team.

Your baby will:

• Be placed under the light in a cot or incubator wearing only a nappy
• Have their eyes protected with a soft mask or shield
• Be monitored regularly to check their temperature and comfort
• Be encouraged to feed frequently to support hydration and bilirubin clearance

Your baby’s bilirubin levels will be checked every few hours. Once the levels start to drop to a safe level, the treatment can be stopped. A final blood test 6 to 12 hours later ensures everything is stable before your baby is discharged.

It can feel unsettling to see your baby under the lights, but try to remember that this treatment is gentle and effective - and it means your baby is getting exactly what they need to recover safely.

What Is Early-Onset Jaundice?

If jaundice appears within the first 24 hours after birth, this is called early-onset jaundice. It may be caused by a mismatch between your blood type and your baby’s, or other medical reasons. Babies with early-onset jaundice are usually monitored closely in hospital and may need a longer stay to ensure they’re safe and well.

What Is Breastmilk Jaundice?

Around 1 in 10 breastfed babies still have mild jaundice at one month of age. This is called breastmilk jaundice. It’s not fully understood why this happens, but it’s believed that components in breastmilk can slightly slow down the breakdown of bilirubin in some babies.

If jaundice persists beyond two weeks, your baby may be invited to a clinic for a blood test to rule out other causes. These are usually rare and include things like liver conditions, urinary infections, or thyroid concerns. In most cases, the baby is healthy and the jaundice resolves slowly without any further treatment. You do not need to stop breastfeeding.

It may take up to 12 weeks for the jaundice to fully fade - and that’s perfectly okay.

What If It’s Something More Serious?

In very rare cases, jaundice can be caused by an underlying liver condition. If your baby needs further investigation, you may be referred to a specialist clinic. The Children’s Liver Disease Foundation (CLDF) offers helpful resources, including a leaflet called Baby Jaundice and Liver Disease, available at www.childliverdisease.org.

Looking After Yourself

Having a jaundiced baby can feel scary, especially if hospital treatment is involved. But remember, you are not alone, and this is something that happens to many babies. Most recover quickly with minimal support.

While your baby is being cared for, make sure you are being cared for too. Eat regularly, drink plenty of water, and rest when you can. If someone offers to help - say yes. Looking after yourself is not selfish. It’s essential, because your baby needs you well too.

You’re doing brilliantly. This might be one of the first bumps in the road, but you’re getting through it - and you will come out the other side stronger and more confident.