Health & safety

Jaundice

Jaundice is yellow color in a newborn’s skin or eyes caused by bilirubin building up in the blood. It is common in the first days, but color alone cannot show whether the level is safe: every newborn needs a measured bilirubin level and a follow-up plan. Yellow color in the first 24 hours needs urgent medical assessment.

Full guide

The dated summary changes with the card you choose. The complete reference below stays available for context and safety.

What you may see right now

Look in bright white light, such as daylight near a window. Yellow color often appears first on the face, then may move to the chest, belly, arms, and legs as bilirubin rises. Check the whites of the eyes and inside the mouth too; jaundice can be harder to see on brown or black skin. The American Academy of Pediatrics (AAP) newborn jaundice guide describes these signs and when to call.

Appearance is only a clue. The AAP recommends a bilirubin measurement through the skin or blood between 24 and 48 hours after birth, or before discharge if that comes sooner. A blood bilirubin level is used for treatment decisions. There is no single treatment number for every baby: clinicians use the baby’s age in hours, gestational age, measured level, and medical risk factors. See the AAP clinical practice guideline on newborn hyperbilirubinemia.

What changes next

Over the first several days: mild jaundice may become easier to see as the newborn liver catches up. Jaundice related to suboptimal milk intake often peaks around days 3 to 5 and may come with excess weight loss, so feeding and follow-up matter.
As feeding settles: waking for feeds, swallowing, wet diapers, and stools should become more consistent. The bilirubin trend—not a visual guess—shows whether the level is safely moving away from the treatment threshold.
Over the first 2 weeks: jaundice clears in many babies. It may last longer in a breastfed baby; “breast milk jaundice” usually begins in the second or later week and can continue for several weeks, according to the CDC’s jaundice and breastfeeding guidance.

These are broad patterns, not deadlines. The AAP guideline recommends total and direct (or conjugated) bilirubin testing when jaundice remains at 2 weeks in a formula-fed baby or at 3 to 4 weeks in a breastfed baby, so the clinician can decide whether more evaluation is needed.

Reassuring signs

Look for a cluster of signs rather than trusting skin color alone:

The bilirubin check and every recommended recheck are complete, and the clinician says the level and trend fit the follow-up plan.
Baby wakes or can be gently roused for feeds, feeds effectively, and seems satisfied afterward.
Wet diapers and stools are becoming more frequent as expected for baby’s age; urine is not dark and stools are not pale or chalky.
Yellow color is not deepening or spreading farther down the body.
If phototherapy was prescribed, it is being used exactly as directed and the scheduled repeat bilirubin checks are happening.

When to call or get help

Call the pediatrician

You do not know the last bilirubin result or when the next newborn check should happen.
Jaundice remains at 2 weeks in a formula-fed baby or at 3 to 4 weeks in a breastfed baby, even if baby otherwise seems well. Ask about total and direct (or conjugated) bilirubin testing.
You have questions about feeding, pumping, supplementation, or a prescribed home phototherapy plan.

Get prompt medical advice

Yellow color appears in the first 24 hours: tell the hospital or birth-center team immediately, or arrange urgent evaluation now if baby is home. The bilirubin level should be measured right away.
Skin becomes more yellow, yellow reaches the belly, arms, or legs, or the whites of the eyes become yellow.
Baby is feeding less effectively, is increasingly sleepy or fussy, or has fewer wet or dirty diapers than the feeding team expects.
Urine is dark yellow or brown, or stool is pale, creamy, gray, or chalky. Current NHS newborn jaundice guidance recommends urgent assessment for these changes.

Get urgent help now

Go to an emergency department now if a jaundiced baby is much sleepier than usual or difficult to wake, will not feed, is floppy or stiff, has jerking or twitching movements, or is struggling to breathe.

Call 911 or your local emergency number if baby cannot be woken, has a seizure, or has severe trouble breathing. Do not wait for a callback when baby appears to have a life-threatening emergency.

Usually not a worry

Mild yellow color after the first 24 hours: this is common and often needs no treatment, but it still needs the scheduled bilirubin measurement and follow-up.
Color that is difficult to judge: visibility varies with lighting and skin tone. This does not mean the risk is higher or lower; rely on measured bilirubin rather than repeated visual checks alone.
Continuing to breastfeed: most newborns with jaundice can keep breastfeeding. The CDC recommends making any decision about expressed milk, donor milk, formula, or a temporary interruption case by case with the health care team.
Jaundice that lasts longer in a thriving breastfed baby: breast milk jaundice can persist for several weeks. It is reassuring only after the clinician has assessed the baby, including the recommended 3- to 4-week check if yellow color remains, and confirmed the follow-up plan.

Useful today

Find the discharge bilirubin result and the exact date or age when the next check is due. Call today if either is unclear.
In daylight, note whether yellow color is spreading. Also note feeding effort, wet diapers, and stool color so you can describe the trend.
If breastfeeding, offer the breast at least 8 to 12 times each day during the first days and get latch or milk-transfer help promptly if feeding is difficult, as the AAP recommends.
Follow the clinician’s feeding plan. Do not start formula supplementation or stop breastfeeding solely because baby looks yellow; those choices depend on intake, weight, bilirubin, and other factors.
Do not place baby in direct sunlight to treat jaundice. Sunlight is not a safe substitute for prescribed phototherapy.