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Jaundiced Newborn

Description

The skin and whites of the eyes are yellow.

Types of Jaundice

  1. Physiological jaundice (50% of newborns):
    1. Onset 2 to 3 days of age
    2. Peaks day 4 to 5, then improves
    3. Disappears 1 to 2 weeks of age
  2. Rh and ABO blood group incompatibility:
    1. Onset during first 24 hours of life
    2. Can reach harmful levels
  3. Breastfeeding jaundice (5 to 10% of newborns):
    1. Due to inadequate intake of breastmilk
    2. Pattern similar to physiological type
  4. Breast-milk jaundice (1% of newborns):
    1. Due to substance in breastmilk which blocks destruction of bilirubin
    2. Onset 4 to 7 days of age
    3. Lasts 3 to 10 weeks
    4. Not harmful

When to Call Your Doctor for Jaundiced Newborn

Call 911 Now If:

  • Unresponsive or difficult to awaken
  • Not moving or very weak

Call Your Doctor Now 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 If:

  • You think your child needs to be seen
  • You are concerned your baby is not getting enough breastmilk
  • Good-sized yellow, seedy stools are < 3 per day (EXCEPTION: not valid until breastmilk comes in on day 4 or 5)
  • Wet diapers are < 6 per day (EXCEPTION: 2 wet diapers/day can be normal until milk comes in on day 4 or 5)
  • Skin looks deep yellow or orange
  • Discharged before 48 hours AND 4 or more days old AND hasn't been examined since discharge (Reason: AAP recommends re-check)

Call Your Doctor During Weekday 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 or reappeared after 7 days of age
  • Stools are white, pale yellow, or gray

Home Care (Read "Call Your Doctor…" first):

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 Stools

Increasing the frequency of feedings will increase the frequency of the stools. (Reason: increased stools carry more bilirubin out of the body).

We do not recommend the use of rectal thermometers to try to increase the stools.

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

Parent Care for Pediatric Symptoms. Copyright 2000-2006.