Newborn jaundice - Treatment 

Treating jaundice in newborn babies 

You should speak to your midwife, health visitor or GP if your baby develops jaundice. They'll be able to assess whether treatment is needed.

Treatment is usually only necessary if your baby has high levels of a substance called bilirubin in their blood, so tests need to be carried out to check this. See diagnosing jaundice in babies for more information about the tests used.

Most babies with jaundice don't need treatment because the level of bilirubin in their blood is found to be low. In these cases, the condition usually gets better within 10 to 14 days and won't cause any harm to your baby.

If treatment is felt to be unnecessary, you should continue to breastfeed or bottle feed your baby regularly, waking them up for feeds if necessary. If your baby's condition gets worse or doesn't disappear after two weeks, contact your midwife, health visitor or GP.

Prolonged newborn jaundice (lasting longer than two weeks) can occur if your baby was born prematurely or if he or she is solely breastfed. It usually improves without treatment. However, further tests may be recommended if the condition lasts this long to check for any underlying health problems.

If your baby's jaundice doesn't improve over time or tests show high levels of bilirubin in their blood, they may be admitted to hospital and treated with phototherapy or an exchange transfusion.

These treatments are recommended to reduce the risk of a rare but serious complication of jaundice called kernicterus, which can cause brain damage.

See complications of jaundice in babies for more information about kernicterus.

Phototherapy

Phototherapy is treatment with light. It is used in some cases of newborn jaundice to lower the bilirubin levels in your baby's blood through a process called photo-oxidation.

Photo-oxidation adds oxygen to the bilirubin so it dissolves easily in water. This makes it easier for your baby's liver to break down and remove the bilirubin from their blood.

There are two main types of phototherapy.

• conventional phototherapy – where your baby is laid under a halogen or fluorescent lamp with their eyes covered
• fibreoptic phototherapy – where your baby lies on a blanket that incorporates fibreoptic cables; light travels through the fibreoptic cables and shines on to your baby's back

In both methods of phototherapy, the aim is to expose your baby's skin to as much light as possible.

Conventional phototherapy is the treatment tried first in most cases, although fibreoptic phototherapy may be used first if your baby was born prematurely.

These types of phototherapy will usually be stopped for 30 minutes every three to four hours so you can feed your baby, change their nappy, and give them a hug.

If your baby's jaundice doesn't improve after conventional or fibreoptic phototherapy, continuous multiple phototherapy may be offered. This involves using more than one light and often a fibreoptic blanket at the same time.

Treatment won't be stopped during continuous multiple phototherapy. Instead, milk that has been squeezed out of your breasts in advance may be given through a tube into your baby's stomach, or fluids may be given into one of their veins (intravenously).

During phototherapy, you baby's temperature will be monitored to ensure they're not getting too hot and they'll be checked for signs of dehydration. Your baby may need intravenous fluids if they're becoming dehydrated and aren't able to drink a sufficient amount.

The bilirubin levels will be tested every four to six hours after phototherapy has started. Once levels start to fall, they'll be checked every six to 12 hours.

Phototherapy will be stopped when the bilirubin level falls to a safe level, which usually takes a day or two.

Phototherapy is generally very effective for newborn jaundice and has very few side effects, although your baby may develop a temporary rash or tan as a result of the treatment.

Exchange transfusion

A blood transfusion, known as an exchange transfusion, may be recommended if your baby has particularly high levels of bilirubin in their blood or if phototherapy hasn't been effective.

During an exchange transfusion, small amounts of your baby's blood are removed through a thin plastic tube placed into blood vessels in their umbilical cord, arms or legs. The blood is then replaced with blood from a suitable matching donor (someone with the same blood group).

As the new blood won't contain bilirubin, the overall level of bilirubin in your baby's blood will fall quickly.

Your baby will be monitored throughout the transfusion process, which can take several hours to complete. Any problems that may arise, such as bleeding, will be treated.

Your baby's blood will be tested within two hours of treatment to check if it's been successful. If the level of bilirubin in your baby's blood remains high, the procedure may need to be repeated.

Other treatments

If jaundice is caused by an underlying health problem, such as an infection, this usually needs to be treated.

If the jaundice is caused by rhesus disease (when the mother has rhesus-negative blood and the baby has rhesus-positive blood), intravenous immunoglobulin (IVIG) may be used.

IVIG is usually only used if phototherapy alone hasn't worked and the level of bilirubin in the blood is continuing to rise.

Learn more about IVIG treatment for rhesus disease.