What is jaundice in a baby?
Jaundice is the yellowish colour of the skin and the whites of the eyes that can appear in the first days of life. It happens because of an increase in a substance called bilirubin in the blood. Bilirubin is produced naturally when the body breaks down old red blood cells. In newborns, the liver is still maturing and may take longer to remove this substance.
In most babies, jaundice is temporary and goes away on its own or with simple treatment. Even so, it should be monitored, because in some cases bilirubin levels can rise too much and require closer medical follow-up.
Why is it so common in newborns?
Jaundice is very common in the first weeks of life. This happens because babies are born with more red blood cells than adults, and those red blood cells are replaced quickly after birth. At the same time, the baby’s liver is not yet fully mature.
Some babies are more likely to develop jaundice, such as those born preterm, those who have difficulty breastfeeding in the first days, those with more bruising at birth, or those with blood group incompatibility with the mother.
What are the signs?
The most visible sign is yellowing of the skin. It usually starts on the face and may spread to the trunk, arms, and legs as bilirubin levels rise. The whites of the eyes may also become yellow.
In many babies, the yellow colour is easier to see in natural light. If you gently press the skin with a finger, you may notice the yellow tone as the colour returns. However, this observation does not replace assessment by a health professional.
Besides yellowing, it is important to watch for other signs, such as excessive sleepiness, difficulty waking for feeds, weak sucking, a high-pitched cry that sounds unusual, or a baby who seems more floppy than usual. These signs need medical evaluation.
When is jaundice physiological, and when is it concerning?
In many babies, so-called physiological jaundice appears after the first 24 hours of life, peaks around days 3 to 5, and then gradually improves. It is a common and expected process in many healthy newborns.
There are, however, situations that need special attention. Jaundice that appears in the first 24 hours of life should never be dismissed. It is also concerning when the yellow colour increases quickly, lasts longer than expected, or comes with other symptoms such as significant weight loss, little urine, very pale stools, or a baby who looks unwell.
How is it monitored?
In Portugal, follow-up is usually done by the paediatrician, family doctor, child health nurse, or the team caring for the baby after birth. In some cases, bilirubin may need to be measured with a device on the skin or with a blood test.
The health professional assesses the baby’s age in hours or days, how intense the yellow colouring is, feeding, weight, urine, stools, and other risk factors. Based on this, they decide whether monitoring is enough, whether the baby needs another check, or whether treatment should start.
What is the treatment?
The most common treatment when bilirubin is high is phototherapy. The baby is placed under a special light that helps the body change bilirubin into a form that is easier to eliminate. This treatment is safe and widely used in hospitals and maternity units.
Alongside phototherapy, it is important to ensure adequate feeding, especially in the first days. Good milk intake helps the baby remove bilirubin through stools and urine. If breastfeeding is difficult, it may be necessary to support latch, increase feeding frequency, or check whether the baby is taking enough milk.
In rare and more serious situations, additional treatments may be needed, always decided by specialist medical teams.
Breastfeeding and jaundice
It is common for parents to worry when a baby has jaundice and is feeding poorly. In the first days, breastfeeding may take some adjustment, and some babies with jaundice become sleepier, which makes feeds even harder.
That is why it is worth observing feeding frequency, sucking quality, and signs that the baby is taking enough milk. The baby should pee regularly and have stools appropriate for their age. If you feel the baby does not wake to feed, feeds very little, or seems weak, you should seek help from a health professional.
If you are breastfeeding and have questions about latch, milk supply, or how often to feed, ask for help early. The sooner support is available, the easier it is to prevent complications and continue breastfeeding safely.
When should you seek urgent help?
Seek medical help immediately if the baby has jaundice in the first 24 hours of life, if the skin becomes very yellow or the colour spreads quickly, if the baby is very sleepy, difficult to wake, has a high-pitched cry, fever, breathing difficulty, stiffness, unusual movements, or persistent refusal to feed.
The baby should also be seen quickly if they have very pale or white stools, very dark urine, signs of dehydration, or marked weight loss. If in doubt, it is always better to call the available health line or contact the health unit that follows the baby.
Can jaundice cause long-term problems?
In most cases, no. When it is detected and monitored in time, jaundice resolves without consequences. The risk of complications increases when bilirubin reaches very high levels and is not treated. That is why the key is to watch for signs, keep follow-up appointments, and follow clinical advice.
Careful monitoring in the first days is a simple way to protect the baby’s health. Even when jaundice is common and expected, observation by parents and the health team makes all the difference.
What can parents do at home?
Parents can watch the colour of the skin and eyes, make sure the baby feeds frequently, keep track of wet nappies and stools, and attend follow-up appointments. If the baby was discharged with mild jaundice, it is important to follow the advice given at the maternity unit or by the paediatrician.
Avoid trying to solve the problem with informal advice or delaying assessment because you think it is “normal” in every case. Jaundice is common, but it is not always the same. The safest approach is to keep a close eye on it and clear up any doubts with the health team.
Final summary
Jaundice in babies is very common and, in most cases, temporary. Even so, it should be taken seriously, especially when it appears early, gets worse quickly, or comes with signs such as excessive sleepiness, difficulty feeding, or changes in urine and stools. With monitoring, good feeding, and clinical follow-up, most babies recover well.
If you have questions, do not wait. Speak to the paediatrician, family doctor, or the health unit following your baby. Early guidance is always the best protection.
