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The skin and whites of the eyes have turned yellow
Types of Jaundice
Physiological jaundice (50% of newborns)
Onset 2 to 3 days of age
Peaks day 4 to 5, then improves
Disappears 1 to 2 weeks of age
Breastfeeding or Malnutrition jaundice (5 to 10% of newborns)
Due to inadequate intake of breastmilk
Pattern similar to physiological type
Also, causes poor weight gain
Breastmilk jaundice (1% of newborns)
Due to substance in breastmilk which blocks destruction of bilirubin
Onset 4 to 7 days of age
Lasts 3 to 10 weeks
Rh and ABO blood group incompatibility
Onset during first 24 hours of life
Can reach harmful levels
Unresponsive or can't be awakened
Not moving or very weak
Newborn starts to look or act abnormal (e.g., decrease in activity or ability to suck)
Feeding poorly (e.g., little interest, poor suck, doesn't finish)
Signs of dehydration (no urine in 8 hours, very dry mouth, sunken soft spot)
Fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen)
Low temperature below 96.8° F (36.0° C) rectally that doesn't respond to warming
Jaundice began during the first 24 hours of life
Skin looks deep yellow or orange
Jaundice has reached the legs
Jaundice worse than when last seen
High-risk baby for severe jaundice (premature baby of 36 weeks or earlier, ABO or Rh blood group problem, sibling needed bili-lights, cephalohematoma, Asian race, breastfeeding problems)
You think your child needs to be seen urgently
You think your child needs to be seen, but not urgently
You are concerned about the degree of jaundice (Exception: only the whites of eyes are yellow)
You are concerned your baby is not getting enough breastmilk
Good-sized yellow, seedy stools are less than 3 per day (EXCEPTION: breastfed and before 5 days of life)
Day 2-4 of life and no stool in over 24 hours and breastfed
Wet diapers are less than 6 per day (EXCEPTION: 3 wet diapers/day can be normal before 5 days of life if breastfed)
Discharged before 48 hours of life AND 4 or more days old AND hasn't been examined since discharge (Reason: AAP recommends re-check)
You have other questions or concerns
Color gets deeper after 7 days old
Jaundice is not gone after 14 days of age
Jaundice began or reappeared after 7 days of age
Stools are white, pale yellow or gray
Mild jaundice of newborn and you don't think your child needs to be seen
Some jaundice is present in 50% of newborns.
It is temporary and usually harmless.
The first place for jaundice to appear is in the whites of the eyes (sclera).
Jaundice that only involves the face and eyes is always harmless.
Bottlefed: If bottle fed, increase the frequency of feedings. Try for an interval of every 2 to 3 hours during the day.
Breastfed: If breastfed, increase the frequency of feedings. Nurse your baby every 1½ to 2½ hours during the day. Don't let your baby sleep more than 4 hours at night without a feeding.
If your baby is 5 days or older AND has less than 3 stools/day, carefully insert a lubricated thermometer ½ inch (12 mm) into the anus and gently move it from side to side a few times to stimulate a stool.
Reason: increased stools carry more bilirubin out of the body
Do this once or twice per day until jaundice improves or stool frequency becomes normal.
Expected Course: Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
Jaundice starts on the face and moves downward. Try to determine where it stops.
View your baby unclothed in natural light near a window.
Press on the skin with a finger to remove the normal skin tone.
Then try to assess if the skin is yellow before the pink color returns.
Move down the body, doing the same. Try to assess where the yellow color stops.
Jaundice that only involves the face and eyes is always harmless. As it involves the chest, the level is going up. If it involves the abdomen, arms or legs, the bilirubin level needs to be checked.
Call Your Doctor If:
Jaundice becomes worse
Legs becomes yellow
Feeding poorly or weak suck
Baby starts to act sick or abnormal
Jaundice not gone by day 14
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