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
- 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