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Jaundice is very common and affects about 6 out of 10 babies. It makes the skin and eyes look yellow. It happens more often in babies born before 37 weeks. Jaundice usually starts 2 to 3 days after birth and goes away by two weeks of age. Most of the time, it is not harmful.

Your newborn should be checked for jaundice at every opportunity, especially in the first 72 hours. This involves looking at your baby in bright light (natural light if possible) to see if they look yellow.

If your baby seems to have jaundice, your midwife should check the bilirubin level at their next routine check. If jaundice appears within the first 24 hours of life, your baby should be checked the same day—contact your midwife right away.

Please see Red-Amber-Green tables for advice on when and where to seek care for your child.

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When should you worry?

RED

When should you worry?

  • Breathing very fast, too breathless to talk, eat or drink 
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up or very sleepy
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)
  • Has a temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.

RED
AMBER

If your child has any of the following:

  • Jaundice appears in the first 24 hours of life
  • Rapid progression in the intensity of 'yellowness'
  • Pale stool - keep a sample to show the doctor
  • Still jaundiced at 2 weeks of life 
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding (less than half of their usual amount) 
  • Irritable (Unable to settle them with cuddles, toys or feeding)
  • Getting worse and I am still worried

You need to contact a doctor or nurse today.

Please contact your GP surgery or call NHS 111 - dial 111.

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

AMBER
AMBER
AMBER
Green

If none of the above features are present

Your baby has had their jaundice recently assessed by a health professional AND

  • Continues to feed well, breast or formula. Has plenty of wet nappies and continues to pass green poo on day 2-3 changing to yellow "seedy" by day 5. Breast fed babies poo can appear "seedy" which are fat deposits within their poo and are a reassuring sign your baby is being well fed.
  • Baby wakes up/cries regularly for feeds.

Additional information is available about infant crying and how to cope.

Self care

Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor, local pharmacist or call NHS 111– dial 111.

Green

Advice and Guidance

Self care and Prevention

Why do babies get jaundice?

It’s completely normal for babies to have mild jaundice. This happens because babies are born with a lot of red blood cells, and when these cells break down after birth, they produce a yellow pigment called bilirubin. Normally, the liver removes bilirubin, but since a baby’s liver is still developing, it can take up to two weeks for the bilirubin to clear. Breastfeeding can also cause mild jaundice, but the benefits of breastfeeding far outweigh this minor issue.

In a small number of cases, there could be a more serious reason for severe jaundice. This might include blood group differences between the mother and baby, higher than normal levels of red cells in the baby (called polycythaemia), or genetic problems with red cells. If there’s a family history of red cell problems, let your midwife know during pregnancy so your baby can be checked with special tests after birth.

Sometimes, jaundice lasts longer than two weeks. If this happens, your baby might need to go to the hospital for further blood tests to find out why. Most of the time, this prolonged jaundice is just because your baby’s liver is taking a bit longer to adjust (called physiological jaundice) or it’s due to breast milk jaundice. Neither of these is harmful to your baby.

Feeding your baby during jaundice

Continue to feed your baby as normal. If you are breastfeeding your baby, continue to breast feed regularly and wake your baby up for feeds if necessary. Sometimes, your midwife or doctor might suggest formula supplementation for a short period to help.

Treatment of neonatal jaundice

In most babies, jaundice doesn’t need treatment and should go away on its own by two weeks of age. Treatment is only needed if the jaundice level is high and likely to rise without help. A healthcare professional will decide if treatment is necessary after checking the baby's jaundice level with either a blood test or a hand-held device. If the level is high, it must be confirmed with a blood test.

The most common treatment for jaundice is phototherapy. This involves keeping the baby under special lights. The light changes the bilirubin in the skin so that the liver can process it more easily. You can click here for a video on phototherapy.

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