Newborn jaundice is a common condition that affects many babies during their first few days of life. While most cases are mild and resolve naturally, some babies may require closer monitoring or treatment to ensure their bilirubin levels remain within a safe range.

At Petite Practice, we understand that seeing your newborn develop jaundice can be worrying. Dr Lee Le Ye provides careful assessment, monitoring and personalised guidance to help parents navigate this common newborn condition with confidence.

What Is Newborn Jaundice?

Newborn jaundice is a condition that causes a yellowish discolouration of a baby’s skin and the whites of their eyes. It occurs when there is a build-up of bilirubin, a yellow pigment produced during the natural breakdown of red blood cells.

Normally, the liver processes bilirubin so that it can be removed from the body through stools and urine. However, a newborn’s liver is still developing and may take some time to process bilirubin efficiently.

Jaundice is particularly common during the first week of life and, in most cases, improves as the baby’s liver matures.

Signs and Symptoms of Newborn Jaundice

Jaundice typically begins on the face and may gradually spread to the chest, abdomen, arms and legs as bilirubin levels increase.

Common signs include:

• Yellowing of the skin, particularly around the face and upper body
• Yellowing of the whites of the eyes
• Increased sleepiness or reduced alertness
• Poor feeding or reduced interest in breastfeeding or bottle-feeding

While mild jaundice may not affect your baby’s behaviour, increasing bilirubin levels can sometimes cause excessive sleepiness and feeding difficulties.

If your baby becomes unusually sleepy, difficult to wake or feeds poorly, seek medical attention promptly.

What Causes Newborn Jaundice?

There are several reasons why newborns may develop jaundice.

1. Physiological Jaundice

Physiological jaundice is the most common type of newborn jaundice. It occurs because a newborn’s liver is not yet fully mature and takes longer to process bilirubin.

This form of jaundice usually appears between the second and fourth day of life and generally resolves within the first two weeks in full-term babies.

2. Breast Milk Jaundice

Breast milk jaundice may develop after the first few days of life, often becoming more noticeable during the first or second week.

It can persist for several weeks, sometimes up to 8–12 weeks, even when a baby is otherwise healthy, feeding well and gaining weight.

Breastfeeding can usually continue, although persistent jaundice should be assessed by a doctor to exclude other underlying causes.

Breast milk jaundice is different from jaundice associated with insufficient milk intake, which can occur when a newborn is not receiving enough milk during the early days of breastfeeding.

3. Blood Group Incompatibility

Sometimes, differences between a mother’s and baby’s blood groups, such as ABO or Rhesus incompatibility, can cause the baby’s red blood cells to break down more quickly.

This can lead to an earlier and more rapid rise in bilirubin levels, occasionally within the first 24 hours of life.

Babies with suspected blood group incompatibility may require additional blood tests and closer monitoring.

4. Other Causes

Less commonly, newborn jaundice may be associated with infections, G6PD deficiency, increased red blood cell breakdown, liver conditions or other medical problems.

Your paediatrician will assess your baby’s condition and determine whether further investigations are necessary.

How Is Newborn Jaundice Diagnosed?

At Petite Practice, Dr Lee Le Ye assesses newborn jaundice by considering your baby’s age, feeding pattern, weight, clinical condition and individual risk factors.

During your baby’s hospital stay, Dr Lee will review your newborn and advise on whether jaundice monitoring is required.

Assessment may include:

Non-invasive bilirubin screening

A handheld device, such as the BiliChek, can be used to estimate bilirubin levels through the skin without requiring a blood sample.

Blood bilirubin testing

If the skin screening result is elevated or a more accurate measurement is required, a small blood sample may be taken to determine the actual bilirubin level.

Individualised risk assessment

Bilirubin results are interpreted according to your baby’s age in hours, gestational age and other clinical risk factors. This helps determine whether monitoring, follow-up testing or treatment is needed.

Treatment Options for Newborn Jaundice

Most babies with mild jaundice do not require specific treatment. However, babies with higher bilirubin levels may need phototherapy.

Phototherapy

Phototherapy is a safe and effective treatment that uses specially designed blue light to help the baby’s body break down bilirubin so that it can be eliminated more easily.

If your baby’s bilirubin level exceeds the recommended treatment threshold, Dr Lee may advise phototherapy.

Treatment typically involves an extended hospital stay, often for at least 24 hours, depending on your baby’s bilirubin levels and response to treatment.

Bilirubin levels will be monitored to determine when phototherapy can be safely discontinued.

In rare cases of extremely high bilirubin levels or rapidly worsening jaundice, more intensive treatment, including an exchange transfusion, may be necessary.

Early detection and appropriate treatment are important because severely elevated bilirubin levels can, in rare cases, cause permanent neurological injury.

Breastfeeding and Newborn Jaundice

Breastfeeding can usually continue when your baby has jaundice.

Frequent and effective feeding helps maintain hydration and encourages regular bowel movements, allowing bilirubin to be eliminated through the stools.

Parents are encouraged to:

• Breastfeed regularly, generally 8–12 times within 24 hours during the newborn period
• Monitor wet nappies and bowel movements
• Ensure their baby is latching and feeding effectively
• Attend scheduled weight and jaundice reviews
• Seek feeding support if their baby is sleepy or having difficulty feeding

Giving additional water or glucose water does not treat jaundice and is not recommended.

Breastfeeding mothers should also avoid unprescribed herbal remedies or traditional preparations, including certain Chinese herbal medicines and jamu, unless their safety has been confirmed by a healthcare professional.

When Should You Seek Medical Attention?

Although newborn jaundice is common, certain signs require prompt medical assessment.

Contact your paediatrician if:

1. Jaundice appears during the first 24 hours of life.
2. The yellow discolouration becomes more noticeable or spreads rapidly.
3. Jaundice persists beyond two weeks of age.
4. Your baby is feeding poorly or not gaining weight adequately.
5. Your baby’s urine appears unusually dark or tea-coloured.
6. Your baby’s stools are pale, cream-coloured, grey or chalky white.
7. Your baby has fewer wet nappies than expected.

Seek urgent medical attention if your baby has a temperature of 38°C or higher, becomes extremely sleepy or difficult to wake, refuses feeds, develops abnormal movements or appears unusually floppy or stiff.

Pale stools and dark urine are particularly important warning signs, as they may indicate an underlying liver or bile duct condition requiring early investigation.

Care After Phototherapy

After completing phototherapy, your baby may be discharged once bilirubin levels have fallen to a safe range and the clinical team is satisfied with their progress.

In some babies, bilirubin levels may rise again after treatment. A repeat bilirubin check may therefore be recommended.

For newborns who are less than seven days old, Dr Lee may arrange an early follow-up appointment to monitor bilirubin levels, feeding and weight gain.

Alternatively, parents may have their baby’s bilirubin levels checked at an appropriate medical facility, such as a polyclinic, according to the recommended follow-up schedule.

Caring for Your Baby at Home

After discharge, parents should continue to:

• Feed their baby regularly and ensure adequate milk intake
• Monitor the number of wet nappies and bowel movements
• Observe for increasing yellow discolouration of the skin and eyes
• Attend all recommended follow-up appointments
• Seek medical advice if their baby becomes unusually sleepy, feeds poorly or has reduced urine output

If jaundice worsens noticeably or your baby is not passing urine as expected, arrange a prompt medical review.

Does Sunlight Help Treat Newborn Jaundice?

Exposing your baby to direct sunlight is not recommended as a treatment for jaundice.

Sunlight exposure does not provide the controlled and reliable treatment delivered by medical phototherapy. It can also increase the risk of sunburn, overheating and dehydration.

If your baby requires treatment for jaundice, medically supervised phototherapy is the recommended approach.

Newborn Jaundice Care at Petite Practice

At Petite Practice, we believe that the early newborn period should be supported by attentive medical care and clear, reassuring guidance for parents.

Dr Lee provides newborn jaundice assessment and monitoring during your baby’s hospital stay, together with follow-up care when needed.

Our approach focuses on early identification of elevated bilirubin levels, timely treatment when indicated, and ongoing support for feeding, growth and your baby’s overall wellbeing.

Whether your baby requires routine jaundice monitoring, follow-up after phototherapy or further assessment for persistent jaundice, we are here to guide your family through these important early weeks.

Concerned about your baby’s jaundice?

Arrange a consultation with Dr Lee at Petite Practice for a personalised assessment and advice on your newborn’s care.