Jaundice is one of the most common conditions in newborns, affecting about 60% of full-term infants and 80% of premature infants. While typically harmless and self-limiting, jaundice requires careful monitoring because very high bilirubin levels can cause brain damage. Understanding the signs, causes, and when to worry helps parents navigate this common newborn condition with confidence.
What Causes Jaundice?
Jaundice occurs when bilirubin — a yellow pigment produced during the normal breakdown of red blood cells — builds up in the blood faster than the baby’s immature liver can remove it. Newborns have a higher red blood cell count than adults, and their livers are not yet fully efficient at processing bilirubin. This combination makes some degree of jaundice almost universal in newborns.
What Does Jaundice Look Like?
Jaundice causes a yellow discoloration of the skin and the whites of the eyes. It typically starts on the face and progresses downward to the chest, abdomen, and legs as bilirubin levels rise. In babies with darker skin, jaundice may be easier to see in the whites of the eyes, palms, and soles. To check for jaundice at home, gently press on your baby’s skin — if the area looks yellow when you release pressure, jaundice may be present.
Physiologic vs. Pathologic Jaundice
Physiologic jaundice is the normal, expected type that appears on day 2-3 of life and resolves within 1-2 weeks. It’s caused by the natural adjustment of the newborn’s liver function. Pathologic jaundice appears earlier (within the first 24 hours), rises more rapidly, or persists longer than expected. It may be caused by blood type incompatibility, bruising from delivery, internal bleeding, enzyme deficiencies, or liver problems. Pathologic jaundice requires medical evaluation and treatment.
Treatment Options
Treatment depends on bilirubin levels and the baby’s risk factors. Mild jaundice is managed with frequent feeding (breast milk or formula helps pass bilirubin through stool). Moderate jaundice may be treated with phototherapy — placing the baby under special blue lights that help break down bilirubin in the skin. Severe jaundice may require intensive phototherapy or, rarely, exchange transfusion. The decision to treat is based on established nomograms that consider the baby’s gestational age, age in hours, bilirubin level, and risk factors.
When to Call Your Pediatrician
- Jaundice appears within the first 24 hours of life
- Yellow color spreads to the abdomen or legs
- Your baby is lethargic, difficult to wake, or not feeding well
- Your baby’s urine is dark or stools are pale/clay-colored
- Jaundice persists beyond 2 weeks for full-term babies or 3 weeks for preemies
- Your baby has a fever
Related: Newborn Rashes: A Field Guide
Disclaimer: If you’re concerned about jaundice, contact your pediatrician immediately. Early treatment prevents complications.
