Jaundiced Newborn

Symptom Definition

  • The skin and whites of the eyes (sclera) are yellow

Types of Jaundice:
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

Call Your Doctor Now (night or day) If

  • Newborn starts to look or act sick (e.g. decrease in activity, ability to suck)
  • Signs of dehydration (very dry mouth, sunken soft spot, no urine in 8 hours)
  • Fever > 100.4°F (38.0°C) rectally
  • Low temperature < 96.8°F (36.0°C) rectally
  • Jaundice began during the first 24 hours of life

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • 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: breastfed and before 5 days of life)
  • Wet diapers are < 6 per day (EXCEPTION: 3 wet diapers per day can be normal before 5 days of life if breastfed)
  • Skin looks deep yellow or orange

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Color gets deeper after 7 days old
  • Jaundice is not gone after 14 days old
  • Jaundice began after 7 days of age

Parent Care at Home If

  • Normal jaundice of newborn and you don’t think your child needs to be seen

Home Care Advice for Mild Jaundice

  1. Bottlefed: If bottle fed, increase the frequency of feedings. Try for an interval of every 2 to 3 hours during the day.
  2. 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.
  3. 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)
  4. Expected Course: Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
  5. 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.
  6. 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