Newborn jaundice affects about 60% of full-term babies and 80% of preterm babies in the first week of life. While most cases resolve naturally, elevated bilirubin levels may require phototherapy. This guide covers the causes, symptoms, bilirubin level guidelines, and treatment options for newborn jaundice.

What is Newborn Jaundice?

Newborn jaundice (Neonatal Jaundice) occurs when high bilirubin levels cause yellowing of the skin and whites of the eyes. Bilirubin is a yellow pigment produced when red blood cells break down.

Why Jaundice Occurs

Newborns have a shorter red blood cell lifespan (70-90 days vs 120 days in adults)
Immature liver function limits bilirubin processing
Rapid breakdown of red blood cells after birth

Types of Newborn Jaundice

Type	Onset	Characteristics
Physiological Jaundice	Day 2-3	Most common, resolves in 1-2 weeks
Breast Milk Jaundice	Day 4-7	Related to breast milk, can continue nursing
Breastfeeding Jaundice	Day 2-3	Due to inadequate feeding
Pathological Jaundice	Within 24 hours	Rapid progression, needs immediate treatment
Prolonged Jaundice	Beyond 2 weeks	May indicate underlying condition

Symptoms of Newborn Jaundice

Jaundice typically starts on the face and spreads downward.

Early Symptoms

Face, especially nose and forehead, turns yellow
Whites of the eyes (sclera) become yellow

Progressive Symptoms

Yellow color spreads to chest and abdomen
Arms and legs become yellow
Yellow palms and soles indicate severe jaundice

Warning Signs (Seek Immediate Care)

Jaundice within first 24 hours
Rapidly progressing jaundice
Poor feeding and lethargy
High-pitched crying
Fever or low body temperature
Back arching

Understanding Bilirubin Levels

Bilirubin levels are the key indicator for assessing jaundice severity.

Normal Bilirubin Ranges

Time	Normal Range	Concern Level
At birth	1-2 mg/dL	Above 5 mg/dL
24 hours	2-6 mg/dL	Above 8 mg/dL
48 hours	6-10 mg/dL	Above 13 mg/dL
Days 3-5	10-12 mg/dL (peak)	Above 15 mg/dL

💡 Phototherapy thresholds vary based on gestational age, birth weight, and postnatal age. Medical assessment is essential.

Bilirubin Testing Methods

Transcutaneous measurement: Device placed on skin (screening)
Blood test: Blood draw for accurate levels

Treatment for Newborn Jaundice

1. Phototherapy

The most common treatment for jaundice.

How It Works

Blue light (460-490nm wavelength) breaks down bilirubin under the skin
Converts it to water-soluble form for excretion through urine and stool

Procedure

Baby lies under special lights wearing only a diaper
Eye protection (eye shields) required
May continue for 24-48+ hours
Home phototherapy blankets (bili blankets) also available

Precautions

Adequate feeding to prevent dehydration
Temperature monitoring
Eye protection essential
Temporary skin rash possible

2. Exchange Transfusion

Used when bilirubin is extremely high or unresponsive to phototherapy.

Indications

Bilirubin levels above 25 mg/dL
Signs of acute bilirubin encephalopathy
Rising levels despite phototherapy

3. Medication

Specific medications may be needed for certain causes.

Intravenous immunoglobulin (IVIG): For Rh or ABO incompatibility
Phenobarbital: Activates liver enzymes (rarely used)

Breast Milk Jaundice and Breastfeeding

Breast milk jaundice does not require stopping breastfeeding.

Breast Milk Jaundice vs Breastfeeding Jaundice

Aspect	Breast Milk Jaundice	Breastfeeding Jaundice
Cause	Breast milk components delay bilirubin excretion	Inadequate intake reduces excretion
Onset	Day 4-7	Day 2-3
Duration	May last 4-12 weeks	Improves with increased feeding
Management	Continue breastfeeding (per doctor)	Increase feeding frequency

Breastfeeding Tips

Start first feeding within 1 hour of birth
Feed 8-12+ times daily
Empty one breast before switching
Monitor wet and dirty diapers (bilirubin excretion)

Home Care for Jaundice

Managing jaundice at home after hospital discharge.

1. Adequate Feeding

Frequent feedings promote bowel movements and urination
Bilirubin is mainly excreted through stool

2. Sunlight

Indirect natural light exposure (avoid direct sunlight)
Limited effectiveness; cannot replace medical treatment

3. Monitoring Jaundice

Check skin color daily under consistent lighting
Natural light observation is most accurate
Watch for spreading of yellow coloration

Jaundice Complication: Kernicterus

Untreated severe jaundice can lead to kernicterus.

What is Kernicterus?

High bilirubin accumulates in brain tissue causing damage
Can cause permanent neurological disabilities

Early Symptoms

Extreme drowsiness, decreased muscle tone
Poor feeding
High-pitched cry

💡 Proper monitoring and early treatment can prevent kernicterus.

When to Return to the Hospital

Seek immediate medical care after discharge if:

Jaundice worsens or spreads to hands and feet
Baby feeds poorly or refuses to eat
Urine is dark yellow or brown
Stool is pale or clay-colored
Baby is limp or unresponsive
Fever or vomiting occurs

Manage Jaundice with BebeSnap

Monitor your baby's jaundice recovery with the BebeSnap app.

Feeding Log: Track feeding frequency and amounts to ensure adequate intake
Diaper Log: Monitor wet and dirty diapers for bilirubin excretion
Health Notes: Record jaundice progression and treatment history
AI Chatbot: Get 24/7 answers to jaundice questions

References

Newborn Jaundice Causes & Treatment | Bilirubin Levels & Phototherapy Guide