Why a newborn can look yellow
Jaundice is caused by a build-up of bilirubin and is common in the first days of life. For many babies it is temporary while the liver adapts to life outside the womb. However, very high bilirubin can injure the nervous system, so “common” does not mean “always harmless”. Skin colour alone cannot show the bilirubin level. A safe assessment considers the baby’s age in hours, gestational age at birth, weight, feeding, risk factors and a measurement through the skin or a blood test.
Jaundice in the first 24 hours
Yellow skin or eyes during the first day of life requires urgent medical assessment. Do not wait for the next scheduled family-doctor appointment or try to grade severity from a photograph. In the maternity unit, tell staff immediately. At home, contact medical care and follow instructions about where the baby should be seen. Very early jaundice may relate to increased breakdown of red blood cells, blood-group incompatibility, infection or another condition that cannot be distinguished at home. The clock starts at birth, not when the family first notices the colour.
Looking for jaundice at home
Observe the baby in daylight rather than under a yellow lamp or through a phone filter. Jaundice often begins on the face and becomes visible over the chest, abdomen and legs, but this direction is not an accurate bilirubin meter. On darker skin, look at the whites of the eyes and gums and at the colour after gently pressing the skin. Each day also observe alertness, feeding, wet nappies, stool colour and temperature. If the colour seems stronger, call and describe the other signs too. A clinician may ask when it began and whether a previous level was measured.
Feeding and fluids
Low milk intake can contribute to rising bilirubin, so the effectiveness of feeding matters as well as frequency. Ask a professional to observe a complete breast or bottle feed and assess weight change and nappies. Wake the baby to feed according to the maternity unit’s or doctor’s instructions. Do not offer water, glucose water or herbal tea unless medically directed; these do not treat the cause and can replace needed nutrition. Any plan for extra expressed milk, donor milk or formula should be made with a professional, without blame about the family’s feeding method. Support for milk transfer and safe supplementation can occur at the same time.
How elevated bilirubin is treated
If a measurement reaches the treatment threshold for that particular baby, a doctor may prescribe phototherapy using special medical light. This is not the same as putting the baby in sunshine. Direct sun can cause overheating and burns, while the dose of light is uncontrolled, so “sun at the window” is not a safe treatment. During phototherapy, the team monitors temperature and feeding, protects the eyes as required by the equipment and repeats bilirubin tests. Other treatment is rarely needed when the level is extremely high or a specific underlying cause is present. Ask when the next measurement will occur and what result would change the plan.
Signs that should not wait
Seek urgent help if jaundice appears during the first 24 hours, becomes obvious on the palms or soles, or the baby is unusually sleepy and difficult to wake, feeds poorly, becomes floppy or very stiff, has a high-pitched cry, fever, low temperature, breathing difficulty or seizures. Very dark urine that stains the nappy and pale, grey or white stool also require medical assessment. Call 113 for a life-threatening condition. The absence of emergency signs does not make steadily increasing jaundice suitable for unsupported home observation; contact the baby’s clinician for a timely measurement.
Who to contact in Latvia
During working hours, call the baby’s family-doctor practice or paediatrician. Outside family-doctor hours, medical advice for a problem that is not clearly life-threatening is available through the Family Doctor Consultation Line on 66016001. The adviser can recommend the next step but cannot measure bilirubin by phone. Have ready the baby’s age in hours or days, gestational age at birth, recent feeds and wet nappies, temperature and discharge information. If you are told to attend an assessment, do not postpone it until a more convenient time. For immediate danger use 113.
After leaving the maternity unit
Before discharge, ask whether bilirubin was measured, what follow-up is planned and exactly where to go on a weekend. A baby with risk factors may need an earlier repeat check. Put the appointment in writing rather than relying on an exhausted memory. Jaundice that lasts longer than the clinician expects or returns needs assessment, particularly with pale stool or poor weight gain. Timely testing is not overreacting; it is the simplest way to distinguish a frequent transitional condition from a problem needing treatment. Bring the maternity discharge summary to every assessment.