Symptom Definition

• The skin and whites of the eyes (sclera) are yellow.

Types of Jaundice

Physiological jaundice (50% of newborns)

• Onset 2 to 3 days of age
• Peaks day 4 to 5, then improves
• Disappears 1 to 2 weeks of age

Rh and ABO blood group incompatibility

• Onset during first 24 hours of life
• Can reach harmful levels

Breastfeeding jaundice

• (5 to 10% of newborns)
• Due to inadequate intake of breastmilk
• Pattern similar to physiological type

Breast-milk jaundice (1% of newborns)

• Due to substance in breastmilk which blocks destruction of bilirubin
• Onset 4 to 7 days of age
• Lasts 3 to 10 weeks
• Not harmful

Call Your Doctor Now (night or day) 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 above 100.4°F (38.0°C) rectally.  
• Low temperature below 96.8° F (36.0°C) rectally.  
• Jaundice began during the first 24 hours of life.  

Call Your Doctor Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen.
• You are concerned your baby is not getting enough breastmilk.
• Good-sized yellow, seedy BMs are less than 3 per day.  (EXCEPTION: not valid until breastmilk comes in on day 4.)
• Wet diapers are less than 6 per day.  (EXCEPTION: 2 wet diapers/day can be normal until milk comes in on day 4.)
• Skin looks deep yellow or orange.  

Call Your Doctor During Weekday Office 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 after 7 days of age.

Parent Care at Home

• Normal jaundice of newborn and you don't think your child needs to be seen.

Home Care Advice for Mild Jaundice

1. Bottlefed:  If bottlefed, increase the frequency of feedings.  Try for an interval of every 2 to 3 hours during the day.
   
   
2. 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.  
   
   
3. Increase BMs:  If your baby is 5 days or older AND has less than 3 BMs/day, carefully insert a lubricated thermometer ½ inch into the anus and gently move it from side to side a few times to stimulate a BM (reason: increased BMs carry more bilirubin out of the body).
   
   
4. Expected Course:  Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
   
   
5. 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.
   
   
6. 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. Barton D. Schmitt, MD, FAAP