Neonatal jaundice is a common condition affecting approximately 60% of full-term and up to 80% of preterm newborns in Asian populations. Characterized by a yellowing of the skin and eyes, jaundice typically appears within the first week of life. While usually harmless and temporary, severe jaundice can lead to serious complications if left untreated. In this article, we’ll explore the symptoms of baby jaundice, why it happens, and steps you can take to ensure your baby stays safe and comfortable.
What is Jaundice?
Jaundice happens when there’s a buildup of bilirubin, a yellow pigment produced when the body breaks down old red blood cells. Newborns naturally have a higher level of bilirubin because their liver is still maturing and may not be able to process it quickly.
Image: Neonatal Jaundice – CNA (Photo: iStock / Smith Assavarujikul)
Infant jaundice is especially common in preterm babies born before 37 weeks and in some breastfed infants. Most full term babies experience mild jaundice that clears up without treatment.
Several factors increase the risk of developing more severe jaundice.
-
Premature babies often struggle to process bilirubin efficiently and may feed less, leading to slower elimination of bilirubin through stool.
-
If the baby’s blood type differs from the mother’s, her body may attack the baby’s red blood cells, causing more bilirubin and more severe jaundice.
-
Breastfed infants, especially those who have difficulty nursing or getting enough nutrition, are also at greater risk, although breastfeeding remains highly recommended due to its many benefits.
-
Studies show that babies of East Asian descent are more likely to develop jaundice, highlighting the importance of careful monitoring in these populations.
In some cases, jaundice may signal an underlying condition and appear earlier or later than usual. These causes can include internal bleeding, infections like sepsis, blood type incompatibilities between mother and baby, liver problems, or blockages in the bile ducts such as biliary atresia. Certain enzyme deficiencies or abnormalities in the baby’s red blood cells that cause rapid breakdown can also lead to jaundice.
Symptoms
Yellowing of the skin and the whites of the eyes — the main sign of infant jaundice — usually appears between the second and fourth day after birth.
According to Mayo Clinic, you can check for infant jaundice by pressing gently on your baby's forehead or nose. If the skin looks yellow where you pressed, it's likely your baby has mild jaundice. If your baby doesn't have jaundice, the skin color should simply look slightly lighter than its normal color for a moment. Examine your baby in good lighting conditions, preferably in natural daylight.
Photo: Use of the jaundice colour card (JCard) on the cheek of an infant by a father - BMJ Paediatrics Open
When to see a doctor
Singapore’s National University Health Systems (NUHS) advises for parents to bring your newborn to the doctor if:
-
Your baby develops Jaundice during the first 48 hours of life, if the level of Jaundice increases rapidly to involve the lower tummy and legs, or jaundice is still present after day 14 of life
-
You have difficulty with breastfeeding, the baby does not pass adequate amounts of stool and urine, and appears more Jaundiced.
-
Your baby's stools turn cream-beige or chalky-white, or if the urine is dark (tea-coloured), and your baby continues to have Jaundice after day 14 of life.
-
Your baby exhibits other warning signs, including but not limited to: lethargy, difficulty waking, poor feeding or weight gain, and unusually high-pitched crying.
Most hospitals routinely check newborns for jaundice before discharge, as early detection is crucial. Jaundice in newborns is usually first noticed during a physical exam when a doctor or nurse sees yellowing of the skin and eyes. To confirm the diagnosis and check the severity, your doctor may perform a bilirubin blood test, which measures the level of bilirubin in the baby’s bloodstream. Mild jaundice usually shows lower bilirubin levels and can be managed with simple monitoring, while higher levels may indicate severe jaundice that requires closer medical attention. Doctors might also choose to check for transcutaneous jaundice by placing a probe or meter on your baby’s chest or head. This measures their transcutaneous bilirubin (TcB) levels.
Treatment options
Mild jaundice in infants usually resolves on its own within two to three weeks. However, babies with moderate to severe jaundice might require a longer stay in the newborn nursery or could need to be readmitted to the hospital for treatment. Common treatments to reduce bilirubin levels include:
-
Improved feeding: To help prevent weight loss and support bilirubin elimination, doctors may suggest feeding your baby more frequently or supplementing their diet to ensure they get enough nutrition.
-
Intravenous immunoglobulin (IVIg): In cases where jaundice is linked to blood type incompatibility between mother and baby, antibodies passed from mother to baby can cause rapid breakdown of red blood cells. IVIg, a blood protein given through a vein, may help lower these antibody levels and reduce jaundice, potentially avoiding the need for more invasive treatments.
-
Exchange transfusion: In rare cases where jaundice is severe and does not improve with other treatments, an exchange transfusion may be necessary. This procedure involves slowly removing the baby’s blood in small amounts and replacing it with donor blood to quickly lower bilirubin and antibody levels. It is performed in a neonatal intensive care unit.
Note: This information is meant to give you an idea of what treatments may involve and is not a substitute for medical advice. Always follow the guidance and recommendations of your healthcare provider.
Prevention and care tips
The best preventive of infant jaundice is adequate feeding. As advised by Mayo Clinic,
-
Breast-fed infants should have eight to 12 feedings a day for the first several days of life.
-
Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week.
-
Supplemental feedings. If your baby is having trouble breast-feeding, is losing weight, or is dehydrated, your doctor may suggest giving your baby formula or expressed milk to supplement breast-feeding. (Note: Check with your doctor what feeding options are right for your baby.)
Keeping your baby well-hydrated and watching for early signs of jaundice are important steps to ensure it doesn’t worsen. Here at CradleNest, we understand that having much needed support can make a world of difference. Download the CradleNest app (available from July 2025) to access expert advice, connect with other parents, and find guidance whenever you need it!
This article was informed by resources from the following:
-
National University Health System (NUHS) — Newborn Jaundice
-
Mayo Clinic — Infant Jaundice: Diagnosis and Treatment
-
Mayo Clinic — Infant Jaundice: Symptoms and Causes
-
Baby Steps Medical — Neonatal Jaundice: What You Should Know
-
SingHealth — Neonatal Jaundice: Symptoms & Treatments
-
KK Women’s and Children’s Hospital (KKH) — Singapore’s First National Clinical Guidelines for Neonatal Jaundice