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Newborn jaundice: When to worry

Newborn jaundice: When to worry

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Babies are monitored closely for jaundice in the newborn period.

Q: My daughter is less concerned about the yellow tint to my new newborn grandson than I am. Should I nag or just relax?

A: Most newborn babies turn at least a little bit yellow. Known as jaundice, this condition is a very common and usually normal part of the newborn period. But in some very rare cases it can lead to (or be a sign of) a more serious problem.

The yellow color of newborn jaundice is caused by high levels of a substance called bilirubin in the blood. Jaundice usually peaks in the first two to five days of life and lasts about one to two weeks. In babies who are breastfed, it can last longer; we don’t know exactly why this happens, but it isn’t anything to worry about.

Jaundice may actually be protective of babies because bilirubin is an antioxidant that may help fight infection in newborn infants. This is another reason why parents shouldn’t be too worried by a bit of yellowness: Not only is it temporary, but it may also be helping their baby as he or she leaves the security of the womb.

Sometimes, though, jaundice can be a sign of another problem, and when bilirubin levels get very high it can affect the brain, sometimes in a permanent way. This is very, very rare, affecting far less than 1% of infants.

Babies are monitored closely for jaundice in the newborn period. Very often, pediatricians use a blood test or a device that measures the bilirubin level through the skin. Based on the result and any risk factors, they decide whether more monitoring or tests are needed, and whether the baby needs therapy.

Feeding is very important, as it helps the body get rid of bilirubin through the blood and urine. Feeding a newborn frequently can also help prevent problems with jaundice. Babies should wet at least six diapers over a 24-hour period and should have stools regularly. The stool should change from the normal newborn black, tarry stools to stools that are lighter in color, and looser and “seedy.”

Call the doctor if your baby:

  • Is looking more yellow, especially if it is spreading down below the knees.
  • Is feeding poorly, and/or isn’t wetting at least six diapers in 24 hours and having regular stools.
  • Is very sleepy, especially if they don’t wake to feed.
  • Is very fussy and hard to console.
  • Arches their head or back, or is otherwise acting strangely.
  • Has a fever or is vomiting frequently.

Remember: Jaundice is common, and serious problems are rare! But call your newborn’s doctor if you are worried; it’s always better to be safe than sorry.

Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School and a senior faculty editor at Harvard Health Publishing. For additional consumer health information, please visit


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