My baby is yellow / jaundice
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.
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 phone 999
- Jaundice appears in the first 24 hours of life
• Rapid progression in the intensity of 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 ring your GP surgery or call NHS Wales 111 - dial 111
- 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 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 advice is also available to young families for coping with crying of well babies – click here.
Self care
Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call NHS Wales 111 – dial 111
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.
How will my baby get checked for jaundice?
All newborn babies get a full head to toe examination within 72 hours of being born. In some instances, jaundice is picked up during this examination. If your baby develops jaundice at home, in most situations, they will not need to see a healthcare professional unless they have any red or amber features (see above). If your baby falls within 'Amber', see a GP or Community Midwife urgently as a blood test may be needed to check their jaundice 'level'. If your baby has any 'Red' features, they will need to be immediately assessed in hospital - dial 999 and ask for assistance from the emergency services.
For more information about testing for jaundice, click here.
Treatment of neonatal jaundice:
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.
Click here for a video on phototherapy.
In very rare instances, where this treatment fails to control the rising level of bilirubin, they may need to undergo a process called an exchange transfusion - where almost all of the baby's blood is exchanged with matching donor blood. This is the most aggressive form of treatment that allows to bring down the bilirubin levels rapidly, thus preventing damage to their brain. Phototherapy lights are very effective these days and it is extremely rare for an exchange transfusion to be needed. In cases of blood group incompatibility, intravenous immunoglobulin may be given to prevent the need for an exchange transfusion.
For further information on treating neonatal jaundice, click here.
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. They provide health education and parenting advice until care is transferred to a health visitor. This usually happens when your baby is about 2 weeks old.
Sound Advice
A midwife is an expert in normal pregnancy and birth.
You can find out more information about your local midwifery team by clicking here.
Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. They provide health education and parenting advice until care is transferred to a health visitor. This usually happens when your baby is about 2 weeks old.
Sound Advice
A midwife is an expert in normal pregnancy and birth.
You can find out more information about your local midwifery team by clicking here.
