Signs of Jaundice in Newborn

Medically reviewed by: Dr. Binu Ninan, MD, Senior Consultant, Neonatology & Pediatrics, Medway Hospitals
Last updated: 5 November 2026

Newborn jaundice causes a yellow tint on a baby’s skin and the whites of the eyes, usually appearing 2 to 4 days after birth. These are the classic signs of jaundice in newborns. It happens when bilirubin, a byproduct of red blood cell breakdown, builds up faster than a baby’s immature liver can clear it. About 6 in 10 newborns, and around 8 in 10 babies born before 37 weeks, develop some degree of jaundice, and most cases are mild and resolve on their own within one to two weeks with frequent feeding.

Warning signs that need same-day medical attention include yellowing within the first 24 hours of life, yellow color spreading to the arms and legs, poor feeding, extreme sleepiness, a high-pitched cry, or arching of the back and neck. Treatment ranges from watchful waiting to phototherapy (light therapy), and in rare severe cases, an exchange transfusion.

Key Takeaways

• The first signs of jaundice in newborns are yellow skin and yellow whites of the eyes, usually starting on the face 2 to 4 days after birth.
• Jaundice in the first 24 hours is never normal. Get your baby checked the same day.
• Yellowing that spreads to the legs, palms or soles, poor feeding, extreme sleepiness, a high-pitched cry or arching of the back need urgent care.
• Pale, chalky stools or dark yellow urine in a jaundiced baby should be reported to your doctor promptly.
• Most jaundice is mild and clears in 1 to 2 weeks with frequent feeding. Sunlight, water or glucose water are not safe treatments.

Introduction

In the first days at home, between feeds and broken sleep, many parents notice something unexpected: their baby’s skin or eyes have taken on a soft yellow tint. That’s newborn jaundice, and it’s one of the most common conditions pediatricians see in the first week of life.

It’s natural to feel a jolt of worry the moment you spot it. Newborn jaundice is usually harmless and temporary. Still, knowing the early signs of jaundice in newborns, and understanding when a case needs closer medical attention, helps you act quickly if it matters, and relax when it doesn’t.

This guide explains what newborn jaundice looks like, why it happens, how doctors diagnose and treat it, and the specific red-flag symptoms that mean it’s time to call your pediatrician.

What is Newborn Jaundice?

Newborn jaundice, medically known as neonatal hyperbilirubinemia, is a yellow discoloration of the skin and eyes caused by an excess of bilirubin in the blood. Bilirubin is a yellow-orange pigment produced naturally when the body breaks down old red blood cells. An adult’s liver processes this waste product easily, but a newborn’s liver is still maturing and often can’t keep pace during the first days of life.

That temporary mismatch, bilirubin production outpacing bilirubin clearance, is what causes the yellow tint parents notice, typically starting on the face and, in higher levels, moving down the body.

How Common Is Jaundice in Newborns?

Jaundice is not rare, and noticing it doesn’t mean something has gone wrong. About 6 in 10 newborns, and around 8 in 10 babies born prematurely, develop some visible jaundice in their first week of life, according to NHS guidance. The vast majority of these cases are mild, resolve without treatment, and leave no lasting effects. A much smaller number of babies develop higher bilirubin levels that need monitoring or light therapy, and a very small fraction develop severe hyperbilirubinemia that requires urgent care. That is exactly why early recognition matters, even though the odds favor an uneventful recovery.

Types of Newborn Jaundice

Not all newborn jaundice is the same. Knowing which type your baby has helps explain the timeline and the likely course of treatment.

Key takeaway: Jaundice that shows up in the first 24 hours of life is never considered “normal” physiological jaundice and always warrants a same-day medical check.

Signs of Jaundice in Newborns: Early and Severe Symptoms

Recognizing the signs of jaundice in newborns early gives you and your pediatrician more time to act if action is needed. Here’s what to watch for, organized by how the condition typically progresses.

Early Signs

In most babies, jaundice starts gently and follows a pattern. Watch for:

• A yellow tint on the face, often first noticed around the nose and forehead.
• Yellow whites of the eyes.
• Yellowing that moves down the body to the chest and tummy as bilirubin rises.
• Yellow gums or inside of the mouth, which can be easier to see in babies with darker skin.
• Sleepiness and shorter feeds than usual.
• Dark yellow urine or pale, chalky stools. A newborn’s urine should be nearly colourless, and stools are usually yellow or green. Pale stools can point to a liver or bile duct problem, so tell your doctor promptly.

Severe or Emergency Signs

These signs suggest bilirubin levels may be high enough to affect the nervous system and need immediate medical attention:

• Jaundice appearing within the first 24 hours of life.
• Yellowing that has spread to the palms of the hands or soles of the feet.
• Extreme lethargy or difficulty waking your baby, even for feeds.
• A high-pitched or unusual cry.
• Poor muscle tone: your baby feels unusually floppy.
• Arching of the back or neck (sometimes called opisthotonus), or unusual stiffness.
• Fever, or a baby who seems unwell in addition to being yellow.

If you notice any of the severe signs above, don’t wait for a scheduled appointment. Contact your pediatrician or go to the emergency department the same day. If your baby cannot be woken, goes stiff or has a seizure, call 108 for an ambulance.

What Causes Jaundice in Newborns?

At its core, jaundice happens when bilirubin production outpaces the body’s ability to remove it. In newborns, several normal and less-common factors can tip that balance.

Normal, Expected Causes

• Liver immaturity. A newborn’s liver enzymes need a few days to ramp up to full bilirubin-processing capacity.
• Higher red blood cell turnover. Babies are born with more red blood cells than they need once they’re breathing air independently, and the breakdown of the surplus cells releases extra bilirubin.
• Loss of placental support. Before birth, the placenta removed bilirubin on the baby’s behalf. After delivery, that job shifts entirely to the baby’s own liver and gut.

Risk Factors That Increase the Chances of Significant Jaundice

• Premature birth (before 38 weeks), since the liver has had less time to mature.
• Blood type incompatibility between mother and baby (Rh or ABO incompatibility), which can cause faster red blood cell breakdown.
• Bruising during delivery (such as from a vacuum- or forceps-assisted birth), which adds extra red blood cells to be broken down.
• Insufficient feeding in the first few days, which slows the excretion of bilirubin through stool.
• A sibling who had significant newborn jaundice.
• East Asian ancestry, which is associated with a statistically higher likelihood of elevated bilirubin levels.
• G6PD deficiency, a genetic enzyme condition that can cause more rapid red blood cell breakdown.

Knowing these risk factors doesn’t mean your baby will develop problematic jaundice. It simply helps your care team decide how closely to monitor bilirubin levels after birth.

How is Jaundice in Newborns Diagnosed?

Diagnosis typically happens in layers, starting with a simple visual check and escalating to blood testing only if needed.

1. Visual assessment. Nurses and pediatricians examine your baby’s skin and eyes in good lighting, both at the hospital and at follow-up visits.
2. Transcutaneous bilirubin (TcB) check. A small handheld device is pressed gently on your baby’s forehead or chest. It estimates the bilirubin level through the skin in a few seconds, with no needle.
3. Total serum bilirubin (TSB) blood test. If the TcB reading is high or the baby has risk factors, a small blood sample confirms the exact bilirubin level. Current AAP guidance recommends checking bilirubin in all newborns within 24 to 48 hours of birth, before hospital discharge, precisely so problematic jaundice isn’t missed.
4. Follow-up monitoring. Your baby’s bilirubin level is plotted against their age in hours, since a “normal” number at 24 hours can be a concerning number at 12 hours. This is why your pediatrician may ask you to return for a repeat check 1 to 2 days after discharge, even if your baby looked fine at first.
5. Additional testing when indicated. If jaundice appears early, is severe, or lasts longer than expected, doctors may check blood type, a direct antibody test (Coombs test), complete blood count, or screen for infection and G6PD deficiency.

How is Newborn Jaundice Treated?

Treatment is guided almost entirely by how high the bilirubin level is, how fast it’s rising, and how many hours old your baby is, not by how yellow your baby looks. Two babies who look equally yellow can need very different levels of care, which is why a proper bilirubin test matters more than a visual guess.

A practical, real-world example: A baby born at 38 weeks who develops mild facial yellowing on day 3, feeds well, and has normal energy will often just need closer breastfeeding support and a follow-up weight and bilirubin check, with no hospital-based treatment at all. In contrast, a baby who is jaundiced within the first 24 hours and appears unusually sleepy will typically be started on phototherapy right away while further testing looks for an underlying cause.

Throughout any treatment, continued breastfeeding or formula feeding is encouraged, since regular feeding helps the baby pass bilirubin out of the body through urine and stool.

What Happens if Jaundice Goes Untreated?

In the overwhelming majority of babies, jaundice resolves on its own or with simple treatment, and there is no lasting effect. Severe complications are rare in babies who receive timely monitoring and care.

However, if very high bilirubin levels go unrecognized and untreated, bilirubin can cross into the brain and cause a condition called kernicterus, a rare but serious and preventable form of brain damage that can affect hearing, movement, and, in severe cases, cognitive development. This is precisely why pediatricians take early signs of jaundice in newborns seriously and why routine bilirubin screening before hospital discharge has become standard practice. The takeaway isn’t that jaundice is dangerous. It’s that timely testing and follow-up make dangerous outcomes very unlikely.

Before You Leave the Hospital: What to Ask and What to Tell Your Baby’s Doctor

Jaundice in newborns can appear or deepen after you go home, so use the discharge conversation well. The American Academy of Pediatrics (AAP) advises parents to ask about their baby’s bilirubin level and schedule a follow-up appointment. Ask these questions before you leave:

• What was my baby’s bilirubin level, and how many hours old was my baby at the test? The AAP says all babies should have at least one bilirubin measurement, by skin or blood test, before discharge.
• On which date should my baby be checked again? Ask for the date before you go home, whatever day you are discharged.
• Does my baby have anything that makes jaundice more likely, such as early birth, bruising from delivery, or breastfeeding that is not yet going well?
• Whom do I call, at any hour, if the yellow spreads or my baby is not feeding well?

What to Tell the Doctor at the Follow-Up Visit

• The day and time you first noticed the yellow colour, and how far it has spread.
• How many feeds, wet nappies and stools your baby had in the last 24 hours, and the colour of the stools.
• Whether a parent, brother or sister had a high bilirubin level and received light therapy as a baby.
• Any medicines the mother is taking, including antibiotics. Do not stop a prescribed medicine on your own. Just mention it.
• Mothballs (often sold as naphthalene balls) kept with the baby’s clothes or bedding, henna, and any herbal remedy used by the mother or given to the baby.

The last two points matter because the AAP asks parents to let the baby’s doctor know if they eat fava beans (broad beans) or use mothballs, antibiotics, henna or herbal remedies. In rare cases these can cause severe jaundice. Do not give your baby any herbal or home remedy for jaundice unless your paediatrician has advised it.

These notes help the doctor. They do not replace a bilirubin test. If your baby looks more yellow, is feeding poorly, is very sleepy or shows any of the severe signs listed earlier, do not wait for the follow-up date. Go to the doctor or the emergency department the same day, and call 108 if your baby cannot be woken, goes stiff or has a seizure.

How to Check Your Baby for Jaundice at Home

Jaundice can appear or deepen after you go home, so a quick daily check in the first week helps. You do not need any equipment.

1. Use natural daylight. Sit near a window during the day. Tube lights and yellow bulbs can hide or exaggerate the colour.
2. Do the press test. Gently press a fingertip on your baby’s forehead, nose or chest for a moment, then lift it. On healthy skin the spot looks paler for a second. If it looks yellow, jaundice is likely.
3. Look at the eyes and gums. NHS guidance notes that yellowing can be harder to see on brown or black skin, and may be easier to spot on the palms, the soles of the feet and the whites of the eyes.
4. Notice how far it has spread. Use the guide below.
5. Check nappies. Count wet nappies and look at the colour of urine and stools.

A home check never replaces a bilirubin test. If you are unsure, or your baby has any of the risk factors above, ask your pediatrician to check the level.

Home Care Tips While Monitoring Jaundice

If your pediatrician has advised watchful waiting at home, these habits support faster, safer recovery:

• Feed on demand, aiming for at least 8 feeds a day.
• Track wet and dirty diapers: a well-hydrated, well-fed baby typically has at least 6 wet diapers and regular stools daily by day 5.
• Check skin color in natural daylight, not under yellow-toned indoor lighting, which can mask or exaggerate the tint.
• Keep all follow-up appointments, even if your baby looks visibly less yellow, because bilirubin trends matter more than a single glance.
• Avoid unsupervised sun exposure as a jaundice treatment. Direct sunlight isn’t a safe or controlled substitute for clinical phototherapy and carries risks of sunburn and overheating in infants.

Common Myths About Newborn Jaundice

Well-meaning advice from family and neighbours is common in the first weeks. Here is what the evidence says:

Signs Your Baby’s Jaundice Is Getting Better

The main sign that newborn jaundice is getting better is that the yellow colour fades, usually from the feet and legs upwards, with the face and the whites of the eyes clearing last. Other good signs are:

• Your baby wakes for feeds and feeds well, at least 8 times a day.
• Plenty of wet nappies, about 6 or more a day by day 5, with pale or colourless urine.
• Yellow or green stools rather than pale or chalky ones.
• Steady weight gain at your follow-up checks.
• A falling bilirubin level on the repeat skin or blood test.

Fading colour alone does not prove the level is safe, so keep every follow-up visit. Jaundice that lasts beyond 2 weeks in a full-term baby, or 3 weeks in a premature baby, needs a check-up even if your baby seems well.

When to Get Medical Advice

While most cases of newborn jaundice resolve without issue, certain symptoms call for prompt medical attention:

• Jaundice appearing in the first 24 hours of life
• Deepening yellow color or rapid spreading over the body, including palms and soles
• Poor feeding, extreme sleepiness, or difficulty waking your baby for feeds
• Fewer wet or dirty diapers than expected
• A high-pitched cry, unusual floppiness, or arching of the back and neck
• Jaundice lasting beyond 3 weeks

If you notice any of these, speak with your pediatrician promptly. It’s always best to err on the side of caution when it comes to your newborn’s health.

Conclusion

Spotting a yellow tint on your newborn’s skin can feel alarming at the moment, but in the vast majority of cases, jaundice is a normal, temporary part of your baby’s transition to life outside the womb. Understanding the early signs of jaundice in newborns, knowing which symptoms need urgent attention, and staying on top of follow-up visits are the best ways to keep your baby safe.

Trust your instincts. If something about your baby’s color, feeding, or alertness seems off, it’s always appropriate to have a pediatrician take a look. That’s what they’re there for. With the right monitoring and care, almost every baby with jaundice goes on to thrive without any lasting effects.