Neonatal Jaundice

Neonatal jaundice is known as the yellowing of the eyes as well as the skin of a baby. Jaundice in newborns is very common and can trigger when babies are high in bilirubin, a yellow pigment that is released during normal red blood cell breakdown. 

The liver absorbs bilirubin in older babies and adults, which then moves it into the intestinal tract. However, the still-developing liver of a newborn may not be mature enough to extract bilirubin.

Fortunately, in most situations, neonatal jaundice disappears on its own when a baby’s liver grows, and the baby begins to eat, which helps bilirubin migrate through the body.

Neonatal jaundice disappears within 2 to 3 weeks in most cases. A symptom of an underlying disorder may be jaundice that lasts for more than three weeks.

In addition, an infant may be at risk for deafness, cerebral palsy, or other types of brain damage from elevated levels of bilirubin.

The American Academy of Pediatrics (AAP) suggest that all newborn babies should be screened for neonatal jaundice prior to hospital discharge and again when they are between 3 and 5 days of age.

The symptoms of neonatal jaundice?

The yellowing of the skin, along with eyes of a baby is the first symptom of neonatal jaundice. Yellowing will start within 2 to 4 days of birth and may begin in the face before spreading throughout the body. 

The levels of bilirubin usually peak from 3 to 7 days after birth. 

If a gently pressed finger on a baby’s skin causes the region of the skin to turn yellow, it is usually a sign of neonatal jaundice.

When to contact a doctor

Most cases of neonatal jaundice are common, but an underlying medical condition may often be suggested by jaundice. The risk of bilirubin entering into the brain, which can cause irreversible brain damage, also increases with extreme jaundice.

Contact your physician if you notice you have these symptoms below:

  • It spreads or becomes more severe with jaundice.
  • A fever over 100 ° F (38 ° C) grows in your infant.
  • The yellow colouring of your baby deepens.
  • Your child eats badly, looks lanky or lazy, and makes high-pitched screams.


The primary cause of neonatal jaundice is an excess of bilirubin (hyperbilirubinemia). Bilirubin is a natural part of the pigment produced from the breakdown of the ‘worn’ red blood cells and is responsible for jaundice’s yellow appearance.

Newborns contain more bilirubin than adults do due to more significant development and faster degradation of red blood cells in the first few days of life. The liver usually filters bilirubin and releases it into the intestinal tract from the bloodstream.

The immature liver of a newborn is frequently unable to extract bilirubin, creating an accumulation of bilirubin rapidly. This jaundice is referred to as physiological jaundice due to these natural neonatal conditions, and it occurs typically on the second or third day of life.

Other causes:

Neonatal jaundice can cause an underlying disorder. It sometimes occurs much earlier or later in these instances than the more typical infant jaundice form.

Diseases or circumstances that can cause neonatal jaundice to include:

  • Internal haemorrhages (bleeding)
  • An illness in the blood of your baby (sepsis)
  • Some diseases that are viral or bacterial
  • An incompatibility between the blood of the mother and the blood of the baby
  • Liver failure
  • Biliary atresia: It is a condition in which the bile ducts of the baby are blocked or scarred
  • Lack of enzymes
  • An abnormality in the red blood cells of your baby that causes them to break down quickly

Risk factors

Major jaundice risk factors, especially severe jaundice that can lead to complications, include:

  • Premature birth: It might not be possible for a baby born before 38 weeks of gestation to absorb bilirubin as easily as full-term babies do. Also, premature babies can eat less and have fewer bowel movements, resulting in less stool-removed bilirubin.
  • Significant bruising during birth: Newborns who get bruised during delivery may have higher bilirubin levels from the breakdown of more red blood cells from delivery bruises.
  • Blood type: The baby may have acquired antibodies via the placenta that trigger an extremely fast degradation of red blood cells if the mother’s blood type differs from that of her baby.
  • Breastfeeding: Breastfed babies are at greater risk of neonatal jaundice, especially those who have trouble breastfeeding or getting enough nutrition from breastfeeding. Dehydration or a low intake of calories can lead to the onset of neonatal jaundice. Nonetheless, experts also recommend it because of the advantages of breastfeeding. Making sure your baby gets enough to eat and is sufficiently hydrated.
  • Race: Studies indicate that the risk of developing neonatal jaundice is increased for babies of East Asian descent.


High bilirubin levels that cause severe jaundice can lead to serious complications If left untreated. A few of the complications include:

Acute Bilirubin Encephalopathy

Bilirubin is toxic to brain cells. There is a chance of transmitting bilirubin through the brain, a disorder called acute bilirubin encephalopathy, if a baby has serious jaundice. Substantial permanent harm can be avoided by timely treatment.

Symptoms of acute bilirubin encephalopathy in a baby with jaundice include:

  • Listlessness
  • Difficulty walking
  • Crying high-pitched
  • Sucking or eating badly
  • Backward arching of the neck and body
  • Fever


The condition that arises if acute bilirubin encephalopathy causes severe brain damage is kernicterus. The outcome of kernicterus may be:

  • Spontaneous and uncontrolled movement (athetoid cerebral palsy)
  • Permanent upward look
  • Loss of hearing
  • Improper growth of tooth enamel

How is jaundice diagnosed in newborns?

The hospital discharges most mothers and newborns within 72 hours of birth. Parents need to bring their babies in for a checkup several days after birth since the bilirubin levels peak about 3 to 7 days after delivery.

A distinct yellow colouring indicates that a child has neonatal jaundice, but further testing may be required to ascertain jaundice’s seriousness. Bilirubin levels should be immediately tested by babies who experience jaundice in the first 24 hours of life, either through a skin test or a blood test.

Additional testing may be needed to see whether a baby’s jaundice is due to an underlying disorder. This could include checking your child for their full blood count (CBC), blood type, and incompatibility with the rhesus factor (Rh).  Additionally, a Coombs test can be performed to check for increased red blood cell breakdown.

How is jaundice treated in newborns?

Generally, mild jaundice can resolve on its own as the liver of a baby starts to develop. Regular feeding can help babies move bilirubin into their bodies (between 8 and 12 times a day).

Other treatment options may be necessary for more severe jaundice. A popular and highly effective treatment technique that uses light to break down bilirubin in your baby’s body is phototherapy.

Your baby will be put under a blue spectrum light on a unique bed during phototherapy while wearing only a diaper and special safety goggles. There may also be a fibre-optic blanket placed under your infant.

An exchange transfusion in which a baby receives small quantities of blood from a donor or a blood bank may be required in severe cases. This substitutes the damaged blood of the baby for healthy red blood cells. This also raises the red blood cell count of the baby and decreases the levels of bilirubin.

Can neonatal jaundice be avoided?

There’s no real way to avoid neonatal jaundice. It would help if you had your blood type checked during pregnancy.

Your baby’s blood type will be reviewed after birth, if possible, to rule out the risk of incompatibility with the blood type that can result in jaundice in the newborn. There are ways of keeping it from being more serious if your baby has jaundice:

  • Make sure that your baby gets adequate nutrition by breast milk. For the first few days, feeding your baby 8 to 12 times a day ensures that your baby is not dehydrated, which allows bilirubin to move through your body faster.
  • For the first week, if you are not breastfeeding, give your baby 1 to 2 ounces of formula every 2 to 3 hours. Smaller quantities of the formula may be taken by preterm or smaller infants, as will babies who are receiving breast milk. Speak to your doctor if your baby is worried about drinking too little or too much milk, or if your baby does not wake up to eat at least eight times every 24 hours.

Carefully check your baby for jaundice signs, like yellowing of the skin and eyes, in the first five days of life. Consult your doctor instantly if you find that your baby has signs of neonatal jaundice.