Jaundice in Infants: What You Need to Know

Noticing that your newborn baby has a yellow tint to their skin can be worrisome, but it’s common. Jaundice is a yellowish discoloration of the skin that commonly happens in infants shortly after birth. In fact, more than 80% of newborns will have some level of jaundice. 

Although jaundice is common, it can have serious consequences if it isn’t diagnosed and treated appropriately. That’s why it’s important to recognize the signs and symptoms.

What causes jaundice in infants?

Jaundice is caused by a buildup of bilirubin in the blood (hyperbilirubinemia). Bilirubin is a compound that forms when red blood cells break down. It’s normally found in blood and bile and removed from the body by the liver. 

There are many reasons for jaundice. Some cause the body to make too much bilirubin. Others stop the body from removing it. Let’s go over some common causes.

Breastfeeding

Breastfeeding is the most common cause of jaundice in otherwise healthy infants, but it’s not always clear why it happens. For some, it may be due to an interaction with breast milk. This can prevent some babies from processing bilirubin in the liver. It usually starts in the first few weeks of life and resolves by 12 weeks. 

In other babies, breastfeeding can lead to jaundice in the first few days of life. This is typically because they aren’t getting enough fluids. Dehydration can lead to a buildup of bilirubin and cause jaundice. 

When possible, it’s important to keep providing breast milk. Breastfeeding should continue as long as the bilirubin levels do not reach dangerous levels.

ABO incompatibility

ABO incompatibility is a condition where an infant and mother’s blood type aren’t compatible. This can happen if the mother has blood Type O and the baby has blood Type A or B. It can also happen if the mother is Rh negative and the baby is Rh positive. 

Antibodies in the mother’s blood can begin to attack the red blood cells of the infant. When the red blood cells are destroyed, it can lead to a buildup of bilirubin and infant jaundice. 

Read more like this

Explore these related articles, suggested for readers like you.

Why Is My Pee Brown? Causes of Dark Pee

What Is Cirrhosis of the Liver? A Guide to Its Causes, Symptoms, and Treatments

Why Is My Pee Orange? Potential Causes to Know

Lupus Took a Toll on Me, But My Support System Helped

View more

Glucose-6-phosphate dehydrogenase (G6PD) deficiency 

G6PD is a protein found throughout the body. It neutralizes harmful compounds that damage cells, especially red blood cells. Infants with abnormal G6PD levels have more red-cell breakdown and more bilirubin in their blood.

Gilbert syndrome

Gilbert syndrome is a common inherited disorder that leads to abnormal processing of bilirubin. These cases are typically mild. And jaundice usually doesn’t occur until adolescence. But it can sometimes happen in infancy.

Viral infections

Severe infections with viruses can cause liver failure in rare cases. If liver function is severely abnormal, bilirubin can’t be removed from the body. This may be the case in infections like:

• Hepatitis

• Herpes

• Enterovirus

Bile blockage

Jaundice can occur when bile can’t empty into the gastrointestinal tract. This sometimes happens when there are abnormalities at birth. Common conditions that affect the flow of bile and lead to jaundice include:

• Biliary atresia

• Alagille syndrome

• Choledochal cysts

What are the symptoms of jaundice in infants? 

Jaundice doesn’t just affect the skin. Jaundice can discolor other parts of the body, too. Because of differences in skin tone, it can be harder to spot on the skin of some babies.  

Common areas to look for discoloration related to jaundice include:

• Skin: Jaundice often appears on the face and then spreads to other parts of the body, like the chest, abdomen, and limbs. Rapidly spreading jaundice may mean that bilirubin levels are very high.

• Eyes: The white parts of your infant’s eyes are one of the earliest places you may see jaundice.

• Under the tongue: The light-pink tissue under the tongue makes it easy to identify color changes.

• Urine: Urine darkens with excess bilirubin. This can be another clue that your infant has jaundice.

• Stool: In some cases of jaundice, the stool may be pale or very light colored.

How do you diagnose jaundice in newborns?

Jaundice is usually diagnosed from the yellowish discoloration of the skin, eyes, or body fluids. Early detection and diagnosis is important to prevent kernicterus — a serious complication of infant jaundice.  

To figure out if your newborn has jaundice, your healthcare team will take several steps:

• Medical history and physical exam: To identify risk factors, it helps to get details about birth history, family history, and medical problems. A physical exam helps find the severity of jaundice and can look for symptoms of kernicterus.

• Blood tests: Bilirubin levels and liver function tests are important in diagnosing jaundice. Specialized tests can check for inherited disorders or viral illnesses.

• Abdominal ultrasound: An ultrasound can look at the liver, bile ducts, and gallbladder. This is helpful if the medical team suspects structural problems. 

What are risk factors for infant jaundice?

Some newborns and infants are more likely to have jaundice and require closer monitoring. Risk factors for jaundice include:

• Prematurity

• Family history (parent or sibling) of jaundice that needed treatment

• Breastfeeding with poor intake

• Scalp hematoma at birth

• Trisomy 21 (Down’s syndrome)

• Large infant born to a mother with diabetes

How do you treat jaundice in newborns?

Jaundice is a treatable condition and rarely causes any permanent issues. Treatment depends on the severity, the infant’s age, and risk factors. 

Most mild cases of jaundice don’t require any treatment and only need observation. But when bilirubin levels get high, your provider will choose the most appropriate treatment.

These treatments prevent worsening jaundice and reduce bilirubin levels:

• Phototherapy: This is the most common infant jaundice treatment. It can take place in the hospital or at home. A blue fluorescent light shines on the skin to help the body remove bilirubin.

• Intravenous immune globulin (IVIG): IVIG is a collection of antibodies given through the vein. It’s particularly effective when treating an infant with jaundice caused by a breakdown of red blood cells.

• Exchange transfusion: Exchange transfusion replaces an infant’s blood with blood from a healthy donor. When bilirubin levels are very high, exchange transfusion may be necessary to prevent kernicterus.

• Surgery: In rare cases, treatment may include surgery. This can help to fix a birth abnormality affecting the liver, gallbladder, or bile ducts.

Is infant jaundice serious?

When infant jaundice is severe and untreated, it can cause kernicterus. This is a neurological condition that causes brain damage. And it’s a medical emergency. 

Symptoms of kernicterus to look for in your baby include:

• Difficulty waking

• Extreme fussiness

• Back arching

• Floppy arms and legs

• Strange eye movements

If your baby has symptoms of kernicterus, you’ll need to seek immediate medical attention.

Why trust our experts?

Written by:

Stephanie R. McGuire, MD, FASA

Stephanie R. McGuire, MD, is a freelance medical writer and pediatric anesthesiologist. She has more than a decade of experience in clinical pediatric anesthesiology, pediatric pain management, and medical education.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Our editorial standards

Meet our experts