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My baby is yellow (jaundice)

Jaundice is extremely common and affects 6 out of every 10 babies. It causes yellowing of the skin and eyes. It is more common in preterm babies (born before 37 weeks). Jaundice usually develops 2 to 3 days after birth and disappears by 2 weeks of age. It is usually harmless. If your baby looks very yellow, health care professionals may do blood tests to check the level of jaundice.

 

Visit the NHS website for more information.

When should you worry?

If your baby has any of the following:

  • Unable to wake
  • Rhythmic jerky movements of arms or legs (a seizure)
  • Pauses in breathing or irregular breathing pattern
  • Pale, mottled and feels abnormally cold to touch
  • Is under 3 months of age with a temperature of 38°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

Go to the nearest Hospital Accident and Emergency Department or phone 999

If your child has any of the following:

  • Jaundice appears in the first 24 hours of life
  • Rapid worsening in the intensity of yellowness
  • Looks very pale and yellow
  • Becoming increasingly sleepy and less interested in feeding
  • Unable to settle (inconsolable)
  • No wet nappies in the last 8 hours
  • Extremely pale (chalk coloured) stool. Keep a sample to show the doctor
  • Jaundice remaining beyond 2 weeks of life (after 3 weeks of life in a premature baby)
  • Is 3 to 6 months of age with a temperature of 39°C or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or more for more than 5 days

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111

We recognise that during COVID, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest A&E

  • Baby looks lightly yellow, mainly on face, which can progress to a mild to moderate intensity in the next day or two, before fading away completely over the next two weeks
  • Continues to feed well, breast or formula. Has plenty of wet nappies and continues to pass green poo on day 2 to 3 changing to yellow and seedy by day 5. Breast fed babies poo can appear seedy which are fat deposits within their poo and are a reassuring sign your baby is being well fed
  • Baby wakes up or cries regularly for feeds
  • Additional advice is also available for families to help cope with crying in otherwise well babies.

Self care

Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call NHS 111

This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire with consent from the Hampshire development groups.

Why do babies get jaundice?

G17-jaundice.jpgIt is completely normal for babies to get mildly jaundiced. That's because babies are born with high levels of red cells in their blood. After birth, as these red cells break down, they produce a yellow pigment called bilirubin. Bilirubin is normally removed by the liver, but as babies have an immature liver at birth, it can take up to 2 weeks for the bilirubin to clear. Breast feeding can cause mild jaundice, however the benefits of breastfeeding far outweigh the mild jaundice that may result.

In a small number of cases, there may be an underlying reason for a baby becoming severely jaundiced. This includes blood group incompatibility between the mother and baby, higher than normal level of red cells in the baby (polycythaemia) or genetic problems with the red cells. If there is a family history of red cell problems, please let your midwife know during pregnancy as your baby may need special tests after birth.

Jaundice occasionally persists beyond 2 weeks of age (beyond 3 weeks for babies born preterm, less than 37 completed weeks). If this happens, your baby may be called in to be assessed and find out why. In most cases the cause for this is just your baby's liver taking a little longer to adapt (physiological jaundice) or breast milk jaundice. These are not a problem for your baby. In most cases the jaundice settles without any treatment.

How will my baby get checked for jaundice?

All newborn babies get a full head to toe examination within 72 hours of being born. In some cases, jaundice is picked up during this examination. If your baby develops jaundice at home, in most situations, they will not need to see a healthcare professional unless they have any red or amber features (see above). If your baby falls within 'Amber', see a GP or Community Midwife urgently as a blood test may be needed to check their jaundice level. If your baby has any 'Red' features, they will need to be immediately assessed in hospital. Dial 999 and ask for assistance from the emergency services.

Visit the NHS website for more information about testing for jaundice.

Feeding your baby during jaundice:

Continue to feed your baby as planned. If you are breastfeeding your baby, continue to breast feed regularly and wake up your baby for feeds if necessary. Formula supplementation, if not by choice, should only be considered if recommended by medical professionals.

 

Treatment of newborn jaundice:

In the vast majority of babies, jaundice does not need treatment and should resolve completely by 2 weeks of age. Treatment is needed only if the baby's jaundice level is high and likely to rise further without treatment. This decision will be made by a healthcare professional after they have checked the baby's jaundice level either with a blood test or by using a hand held device (which, if high, needs to be confirmed by a blood test).

The most common form of treatment is phototherapy. This is where a baby is kept exposed under a special light in the hospital. This light alters the pigment bilirubin and makes it easier to be processed by the liver. Phototherapy can be administered on the postnatal ward or children's ward. If the jaundice level does not come down as expected, then this treatment may need to be intensified. Here is a video on phototherapy.

In very rare instances, where this treatment fails to control the rising level of bilirubin, they may need to undergo a process called an exchange transfusion. This is where almost all of the baby's blood is exchanged with matching donor blood. This is the most aggressive form of treatment that allows to bring down the bilirubin levels rapidly, thus preventing damage to their brain. Phototherapy lights are very effective these days and it is extremely rare for an exchange transfusion to be needed. In cases of blood group incompatibility, intravenous immunoglobulin may be given to prevent the need for an exchange transfusion.

Visit the NHS website for further information on treating neonatal jaundice.

Complications

In a vast majority of babies, jaundice does not lead to any long term complications. However, in less than 1 in 100,000 babies, extremely high levels of jaundice may affect the baby's brain leading to a condition called kernicterus.

Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. They provide health education and parenting advice until care is transferred to a health visitor. This usually happens when your baby is about 2 weeks old.

Sound Advice

 

A midwife is an expert in normal pregnancy and birth.

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand. Watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance