Introduction

Jaundice happens when there is a build-up of a yellow substance called bilirubin in the body. Bilirubin is made when red blood cells break down. It is normally removed by the liver. 

Newborn babies have more red blood cells than adults, and their livers are not developed enough to remove bilirubin quickly. This causes it to build up in the skin. 

Is Jaundice common?  

Jaundice is very common in newborn babies. Most jaundice is normal and usually goes away if your baby is feeding well. Some jaundice happens because of a medical condition that needs attention.  

Babies are more likely to develop jaundice if they:

• were born prematurely, before 36 weeks
• have an infection,
• have rhesus disease – a condition where antibodies in a pregnant woman's blood attack the baby's red blood cells
• have liver disease, like biliary atresia.

Why does jaundice happen?  

Before birth, your baby has extra red blood cells that carry oxygen. After birth they don’t need as many of these cells. The extra red blood cells break down and release bilirubin which is a yellow colour. Your baby looks jaundiced (yellow) when there is a build-up of bilirubin in their skin. Bilirubin is passed out in their poo and wee. This is why it is important for your baby to feed well and often in the early days. This frequent feeding helps to move the bilirubin out of their body.  

There are other reasons why your baby may become jaundiced. Your healthcare provider will talk with you about these.  

How can I tell if my baby has jaundice?   

If your baby has jaundice, their skin and white parts of the eyes will look a yellow colour. The more of their body which is yellow, the more jaundice they have. It starts at the face and then moves down the body to the chest, and then the legs.  It can be harder to see in babies with darker skin tones.    

Jaundice usually fades by the end of the first week of life. It can be more serious if it:  

• starts in the first 24 hours after birth
• lasts longer than 2 weeks after birth 

If jaundice lasts more than two weeks, it could be a sign of another problem, like an infection. 

Seek help from your healthcare provider as soon as possible if your baby:  

• appears jaundiced (yellow) in the first 24 hours of life
• is sleepy and needs to be woken for feeds (babies need 8–12 feeds in 24 hours)
• has dark-coloured wee
• has pale or clay-coloured poo (see chart below)
• has jaundice that spreads down their body
• becomes increasingly jaundiced after phototherapy has stopped
• is very unsettled or vomiting a lot 

If you are concerned and: 

• still in hospital, speak to your doctor, nurse or midwife.
• at home, see your local doctor, midwife or child and family health nurse. 

Your baby’s midwife, nurse or doctor will check their skin and eyes for signs of jaundice after they are born. 

Bilirubin can be measured using a transcutaneous bilirubinometer which is a device that is placed gently against your baby’s skin and provides a bilirubin level in seconds.   

Your baby may also need: 

• a blood test to check:
• how well their thyroid is working
• how well their liver is working
• bilirubin levels. 

If these tests show signs of liver disease, your baby will be referred to a specialist paediatric doctor.  

Will jaundice hurt my baby?   

Most babies with jaundice will be fine. Any baby with jaundice needs to be checked by a healthcare provider.  

Sometimes babies with extremely high jaundice levels may have problems as they get older. In rare cases, very high levels of bilirubin can affect the brain and have an impact on hearing, vision or movement. This is called kernicterus. This can usually be prevented by early diagnosis and treatment of jaundice.   

• Mild jaundice in the first week is usually treated by giving your baby extra feeds of breast milk or formula. Feeding your baby at least every 2–3 hours helps clear bilirubin naturally. If you need help with breastfeeding, talk to your healthcare provider or contact the National Breastfeeding Helpline .

• Moderate jaundice is treated with phototherapy. This is when a special blue light is used to break down the bilirubin. Your baby will be placed under a light or on a light blanket, wearing only a nappy and an eye mask.   

  Phototherapy can make your baby’s poos more runny, so they will be given extra feeds of breast milk or formula. 

  Phototherapy is not the same as sunlight. Do not use sunlight to treat jaundice. Sun exposure is not safe for newborns.

• Severe jaundice is rare and may be treated with a blood transfusion  or immunoglobulin infusion. This is a procedure where donated blood is given to your baby to wash the bilirubin out of their system. 

What can I do?  

If your baby is sleepy and not feeding well, seek help from your healthcare provider. If you are unable to get an appointment with your healthcare provider, call healthdirect to get guidance or take the baby to the emergency department of your local hospital.  

Feeding your baby often (at least every 2-3 hours) helps your baby pass the bilirubin in their poo. If you need help with breastfeeding, you can talk to your health care provider. You can also call the National Breastfeeding Helpline .  

If your baby has been treated for jaundice, get your baby checked by your healthcare provider within 1 to 3 days of leaving hospital or being discharged home. Your baby’s jaundice will be checked along with their weight, feeding, wee and poos. You can also talk about any worries you may have.   

Translated factsheets may not reflect the current information in English