Newborn jaundice: what is normal and when to get help
Noticing a yellow tint in your newborn's skin or the whites of their eyes can feel alarming, but jaundice is one of the most common conditions seen in the first days of life. It is usually harmless and goes away without any treatment. This article, based on NHS guidance, explains what is happening, what the normal course looks like, how you can help your baby through it, and exactly which signs should prompt you to call for help.
What is newborn jaundice?
Jaundice is a condition that causes the skin and eyes to turn yellow. In newborns, it happens because the liver is not yet able to work at full capacity right away. As a result, a waste product called bilirubin builds up in the blood. Bilirubin forms naturally when old red blood cells are broken down, and in older children and adults the liver removes it efficiently. A newborn's liver simply needs a little time to catch up, and it usually does so within a few weeks.
In some cases there are additional reasons why bilirubin builds up more than usual. These include a difference in blood type between a mother and her baby, certain infections, or conditions that affect how the liver functions. Your care team will assess your baby's individual situation and look into any underlying causes if they think it is needed.
What the yellowing looks like
The yellow colour tends to appear first on the face and the top of the head before spreading downward. You may also notice it in the whites of your baby's eyes, under their tongue, and inside their cheeks. The change in colour is easiest to see in bright natural light. On babies with darker skin tones, the yellowing can be harder to spot on the skin, so checking the eyes and the inside of the mouth is particularly helpful.
Jaundice typically becomes most noticeable when a baby is around three days old. This is completely expected and does not by itself mean something is wrong.
How midwives and doctors check for it
In the first days after birth, your midwife or health visitor will check your baby's colour as a normal part of their observations. If jaundice is suspected, bilirubin levels can be measured in two ways: through a blood test, or by pressing a small light-sensing device against your baby's skin. If results suggest a more serious underlying cause, additional checks such as blood tests, urine tests, or an ultrasound scan of the liver may be arranged.
The normal timeline
For the majority of newborns, jaundice follows a predictable pattern. It shows up in the first few days, tends to peak around day three, and then gradually fades. Most babies are completely clear within about two weeks, without needing any specific treatment at all. Knowing this can make the waiting feel much more manageable.
How feeding helps
One of the most effective things you can do at home is to make sure your baby is feeding well and regularly. Frequent feeding helps the gut move waste through the body, which in turn helps clear bilirubin. The NHS recommends aiming for around 8 to 12 feeds every 24 hours. Because jaundice can make some babies feel sleepy, they may not always wake and signal hunger themselves. If your baby is unusually drowsy, it is fine to gently wake them for a feed rather than waiting for them to stir.
Whether you are breastfeeding or using formula, the advice about feed frequency is the same: keep it regular and do not let long gaps build up.
When treatment is needed: phototherapy
Many babies with jaundice need nothing more than time and good feeding. However, if bilirubin levels are high enough to require treatment, the most common approach is phototherapy. This involves shining a special light directly onto your baby's skin. The light changes the structure of bilirubin in a way that makes it easier for the body to process and remove.
Phototherapy is usually given while your baby lies in a cot in hospital, though in some situations home equipment can be arranged. Most babies who need this treatment receive around 48 hours of it. In rare cases, other treatments such as medication or a blood transfusion may be necessary, but your care team will guide you through any of those decisions if they arise.
Warning signs: when to contact a midwife or NHS 111
Contact your midwife or call NHS 111 if your baby is more than 24 hours old and you notice any of the following:
- You think your baby has jaundice for the first time and have not yet had it assessed.
- The yellow colour is not improving or seems to be spreading and getting worse.
- Your baby's urine is dark yellow or brown.
- Your baby's poo is a pale, creamy colour rather than the usual yellow or mustardy shade.
Warning signs: when to call 999 or go to A&E immediately
Some signs alongside jaundice require emergency attention. Call 999 or go straight to A&E if your baby:
- Is less than 24 hours old and already showing signs of jaundice.
- Is sleepier than normal or is difficult to wake.
- Is not feeding.
- Has a temperature of 38C or above, or a low temperature of 36C or below.
- Seems floppy or stiff, or has jerking or twitching movements.
- Has not produced any wet nappies.
- Is having difficulty breathing.
These signs together with jaundice can point to a situation that needs to be assessed without delay. Trust your instincts: if something feels wrong, seek help.
Frequently asked questions
When does newborn jaundice usually appear?
Jaundice in newborns typically becomes most noticeable around day three of life. The yellowing usually starts on the face and head before spreading further. It can be easier to spot in bright light, and checking the whites of the eyes is helpful for all skin tones.
How long does newborn jaundice last?
For most babies, jaundice resolves on its own within about two weeks. Keeping up regular feeds helps the body clear bilirubin more efficiently during this time.
What causes jaundice in a newborn?
Jaundice happens because a newborn's liver is not yet able to remove bilirubin efficiently. Bilirubin is a waste product produced when red blood cells break down. When it builds up in the blood, it gives the skin and eyes a yellow colour. The liver usually matures and catches up within a few weeks. Occasionally a blood type difference between mother and baby, certain infections, or a liver condition can contribute.
When should I call for urgent help about jaundice?
Call 999 or go to A&E immediately if your baby has jaundice and is sleepier than normal or hard to wake, is not feeding, has a temperature of 38C or above or 36C or below, seems floppy or stiff, has jerking movements, has not produced wet nappies, or is having trouble breathing. Also seek emergency care straight away if your baby is less than 24 hours old and already showing jaundice.
What is phototherapy for jaundice?
Phototherapy uses a special light shone onto your baby's skin to help the body break down and remove bilirubin. Most babies who need it receive around 48 hours of phototherapy, usually while lying in a cot in hospital, though home equipment is sometimes used as well.
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