Jaundiced Newborn

Symptom Definition

Physiological jaundice (50% of newborns) Onset 2 to 3 days of age Peaks day 4 to 5, then improves Disappears 1 to 2 weeks of age	Breastfeeding jaundice (5 to 10% of newborns) Due to inadequate intake of breastmilk Pattern similar to physiological type
Rh and ABO blood group incompatibility Onset during first 24 hours of life Can reach harmful levels	Breast-milk jaundice (1% of newborns) Due to substance in breastmilk which blocks destruction of bilirubin Can reach harmful levels Onset 4 to 7 days of age Lasts 3 to 10 weeks Not harmful

You think your child needs to be seen
You are concerned your baby is not getting enough breastmilk.
Good-sized yellow, seedy BMs are < 3 per day
(EXCEPTION: not valid until breastmilk comes in on day 4)
Wet diapers are < 6 per day
(EXCEPTION: 2 wet diapers/day can be normal until milk comes in on day 4)
Skin looks deep yellow or orange

Bottlefed: If bottle fed, increase the frequency of feedings. Try for an interval of every 2 to 3 hours during the day.
Breastfed: If breastfed, increase the frequency of feedings. Nurse the baby every 1½ to 2½ hours during the day. Don't let the baby sleep more than 4 hours at night without a feeding.
Increase BMs: If your baby is 5 days or older AND has < 3 BMs/day, carefully insert a lubricated thermometer 1/2 inch into the anus and gently move it from side to side a few times to stimulate a BM. (Reason: increased BMs carry more bilirubin out of the body)
Expected Course: Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
Judging Jaundice: View your baby unclothed in natural light near a window. Press on the yellow skin with a finger to remove the normal skin tone. Then assess the jaundice color before the pink color returns.
Call Your Doctor If
- Jaundice not gone by day 14
- Your baby is not getting enough milk. (needs a weight check)
- Your baby starts to act sick
- Your child becomes worse or develops any of the “Call Your Doctor” symptoms