Neonatal Jaundice Management
Most newborns become a little yellow in the first week, and most of it is harmless. What matters is the level, how fast it is rising and how old the baby is. Those questions are answered with a blood test, not by looking, because the eye is unreliable and the treatment is simple when started in time.
- Level measured, not judged by eye
- Phototherapy is straightforward and effective
- Feeding continues throughout treatment
- The commonest cause of newborn readmission
Stay
1 to 3 days typically
Duration
Phototherapy for 24 to 48 hours in most cases
Anaesthesia
Not applicable
About Neonatal Jaundice Management
Jaundice comes from bilirubin, a normal breakdown product that a newborn's liver clears slowly at first. In most babies the level rises, peaks around day three to five, and falls. Treatment is needed when the level crosses a threshold set by the baby's age in hours and their risk factors. Phototherapy uses light to convert bilirubin into a form the baby can excrete, and it works well.
- Bilirubin level is measured against age in hours, not days
- Jaundice in the first 24 hours is always significant
- Phototherapy is effective and has few side effects
- Feeding frequently helps clear bilirubin
Before you read on
Everything here is general information about neonatal jaundice management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest neonatal jaundice management.
- Newborns appearing yellow in the first week
- Jaundice appearing within the first 24 hours
- Jaundice persisting beyond two weeks
- Babies with blood group incompatibility with the mother
- Preterm or low birth weight babies, who are at higher risk
- Babies readmitted after discharge with jaundice
Procedure details
The usual sequence, from first consultation through to follow-up.
Measuring the level
A blood test, or a skin measurement for screening, gives the bilirubin level, which is plotted against the baby's age in hours.
Deciding on treatment
The level is compared with the treatment threshold for that age and any risk factors. Many babies need only observation and feeding.
Phototherapy
The baby lies under blue light wearing eye protection and a nappy only. Feeding continues, and the light is paused for feeds.
Rechecking
The level is repeated after a set interval. Phototherapy stops once the level is safely down and not rebounding.
How to prepare
What to sort out before you come in.
- Nothing to prepare, as this is usually identified in hospital or at a check
- Feed frequently, as this helps clear bilirubin
- Tell the team your blood group and the baby's father's if known
- Mention any jaundice needing treatment in previous children
- Report a baby looking yellow in the first 24 hours immediately
Recovery
What to expect afterwards, and roughly when.
- Most babies need 24 to 48 hours of phototherapy
- Feeding continues throughout and should not be reduced
- A rebound check is often done a day after stopping treatment
- Mild jaundice can persist for a couple of weeks in breastfed babies and is usually harmless
- Return if the baby becomes yellow again, feeds poorly or is unusually sleepy
Why choose Humayun for newborn jaundice
Jaundice is the commonest reason newborns come back to hospital, and almost all of that is preventable with a measured level.
- Bilirubin measured rather than estimated by eye, which is unreliable even for experienced staff
- Levels plotted against age in hours, which is what the treatment threshold actually depends on
- Phototherapy available on the postnatal ward, so mother and baby usually stay together
- A rebound check before discharge, because readmission is what good management prevents
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