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Jaundice in babies

Advice for professionals

When should you worry?

If your baby has any of the following:

  • 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’)
  • Jaundice appearing in the first 24 hours of life (If your baby develops jaundice within the 24 hours of life, contact your midwife or hospital straight away to be reviewed and have their jaundice checked).
  • 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- consider using ‘What 3 words’ to best describe location to ambulance service

If your baby has any of the following:

  • Rapid progression in the intensity of ‘yellowness’
  • Looks very pale and yellow
  • Becoming increasingly sleepy and less interested in feeding
  • Unable to settle (inconsolable)
  • No wet nappies in the last 8 hours
  • Extremely pale (chalk coloured) stool- keep a sample to show the doctor
  • Jaundice remaining beyond 2 weeks of life (after 3 weeks of life in a premature baby)
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

 

 If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

If none of the above features are present:

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 "seedy" 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 information is available about infant crying and how to cope – 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 111 – dial 111

This guidance was last reviewed 27/06/2025.

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.

 

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.

 

All Parents, carers and healthcare professionals should all look for jaundice. 
When looking for jaundice (visual inspection):
  • Bright, natural light: Examine the baby in a well-lit room, preferably with natural light. 
  • Areas to check: Pay close attention to the sclera (whites of the eyes), gums, and blanched skin (skin that turns pale when pressed). 

  • Important to also check the baby's nappies for dark urine or pale chalky stools. Urine that is persistently yellow and which stains the nappy and stools that are persistently pale in colour may indicate that there is a problem.

  • When to be concerned: Jaundice appearing in the first 24 hours or worsening jaundice warrants immediate medical attention. 

  • Consider skin tone: Jaundice can be harder to detect in babies with darker skin tones. in addition to the whites of the eyes and gums other options include checking for yellowing on the palms of the hands or the soles of the feet, which could be easier to see in babies with darker skin tones. Urine that is persistently yellow and which stains the nappy and stools that are persistently pale in colour may  indicate that there is a problem.

  • Not a definitive test: Visual inspection alone is not enough to determine the severity of jaundice. It is a starting point, and further testing (like bilirubin level checks) is usually needed. 
  • Seek professional help: If you suspect your baby has jaundice, consult a doctor or midwife promptly. 
  • Follow-up: If jaundice is diagnosed, follow your healthcare provider's instructions for monitoring and treatment. 

While visual inspection is a useful first step in checking for jaundice, it's important to be aware of its limitations and to seek professional medical advice if you suspect your baby has jaundice. Bilirubin level checks are essential for accurate diagnosis and treatment. 

 

For more information about testing for jaundice, click here.

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.

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. You can 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.

In a vast majority of babies, jaundice does not lead to any long-term complications. However, in less than 1 in 100,000 babies, extremely high levels of jaundice may affect the baby's brain leading to a condition called kernicterus.

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