saudigastro.com/patients/neonatal-jaundice
Category
Common
Red flags
5
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Jaundice means a yellow colour of the skin and the whites of the eyes. It is caused by bilirubin, a yellow substance made when old red blood cells break down. Newborns make a lot of bilirubin and their liver is still learning to clear it, so many healthy babies become yellow in the first week. This usually settles by itself. However, very high bilirubin can be harmful to the brain, so levels must be checked and treated when needed.
How common is it?
Newborn jaundice is very common, especially in the first week of life, and more so in babies born early. Most cases are mild and need no treatment beyond good feeding and observation.
Why does it happen?
Common (physiological) jaundice happens because babies have more red blood cells to break down and an immature liver. It can be increased by poor feeding, dehydration, prematurity, bruising from delivery, or a blood group mismatch between mother and baby (for example ABO or Rhesus differences). Some babies have inherited enzyme conditions such as G6PD deficiency, which can cause quick and severe rises in bilirubin. Jaundice that starts within the first 24 hours, or lasts beyond two weeks, can have a more serious cause and needs a doctor's review.
Symptoms
- Yellow colour of the skin, usually starting on the face and moving down the body
- Yellow colour of the whites of the eyes
- Sleepiness and difficulty waking for feeds
- Poor feeding or fewer wet and dirty nappies
- Yellow colour may be harder to see on darker skin tones; check the eyes, gums and the palms and soles
Red flags — seek urgent medical care
Yellow colour in the first 24 hours of life
This is never normal and needs urgent medical assessment the same day.
Very sleepy, floppy, hard to wake, high-pitched cry, arching of the back, or poor sucking
These may be signs that bilirubin is affecting the brain. This is an emergency; go to the emergency department immediately.
Yellow colour spreading to the belly, legs, palms or soles, or getting deeper
Suggests higher bilirubin. Have your baby checked urgently, the same day.
Pale or chalky stools with dark urine, or jaundice lasting beyond 2 weeks
May point to a liver or bile duct problem such as biliary atresia, which needs urgent specialist testing.
Fever, poor feeding, or fewer than expected wet nappies
Possible infection or dehydration. A baby who needs urgent care should be seen immediately.
How is it diagnosed?
The doctor or midwife checks the baby and measures bilirubin, either with a light meter placed on the skin or with a small blood test. The level is compared to charts that take into account your baby's age in hours and risk factors. If the level is high, further blood tests may check blood groups, blood count, and G6PD, and look for infection.
Outlook — what to expect
Most babies recover completely, and jaundice fades within about two weeks. When bilirubin is treated in time, serious complications are very rare. Missing very high levels, however, can cause permanent brain injury, which is why early review and follow-up are important.
Treatment
Habits & Lifestyle
Watching closely and feeding well are the most useful things parents can do.
- Check your baby's skin and eyes in good daylight each day, pressing gently on the skin.
- Count wet and dirty nappies. Fewer than expected can signal poor feeding.
- Attend every follow-up visit after discharge, especially if you left hospital within the first day or two.
- Do not rely on putting your baby in direct sunlight to treat jaundice. It is not a safe or reliable treatment and can cause sunburn and overheating.
- Do not give water, herbal drinks, sugar water or any traditional remedy to treat jaundice.
Diet
Frequent, effective feeding helps the baby pass bilirubin out in stools and urine.
- Feed at least 8 to 12 times in 24 hours, and wake a sleepy baby for feeds.
- Breastfeeding should continue. Ask a midwife or lactation consultant for help with latch and milk supply.
- If feeding is not going well, your doctor may advise extra expressed milk or formula. Do not stop breastfeeding without advice.
- Do not give water or dextrose water in place of milk.
Medications
Most babies do not need any medicine for jaundice.
- Medicines are not the main treatment for common newborn jaundice. Phototherapy (special light) is.
- In rare cases with a blood group problem, the doctor may give special treatment in hospital.
- Do not give any herbal or traditional medicine to a newborn. Some can be harmful, and babies with G6PD deficiency can be at risk from certain substances. Ask the doctor before giving anything.
Procedures & Surgery
Phototherapy is safe and effective when needed.
- Phototherapy uses special blue light to help the body break down bilirubin. The baby lies in a cot or on a light blanket with eyes protected, and keeps feeding.
- Bilirubin is re-checked during and after treatment, and phototherapy is stopped when levels are safe.
- Very rarely, when the level is dangerously high, an exchange blood transfusion is done in a neonatal intensive care unit.
Living with the condition
- If your baby needs phototherapy, you can usually still hold and feed them for short breaks. Ask the staff.
- Know the signs to look for at home and have a plan to reach care quickly at any time of the day or night.
In the Saudi context
G6PD deficiency is a known cause of severe newborn jaundice in the region, and it can be triggered by some substances, so always tell any doctor or pharmacist if G6PD deficiency runs in your family or if your baby has been tested. Avoid traditional remedies and kohl for newborns.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- What is my baby's bilirubin level and what does it mean for their age?
- Does my baby need phototherapy or further tests such as blood group or G6PD?
- When should we have the next bilirubin check?
- How do I know feeding is going well enough?
- Which signs mean I should come back to hospital at once?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide