Jaundice in newborns
Checking and measuring jaundice (yellow colouring) in a newborn baby to find out how high the bilirubin level is and whether treatment or further tests are needed.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Most newborn jaundice is common and harmless, but it must be checked because a few causes are serious and need prompt treatment.
- Jaundice in the first 24 hours of life always needs urgent assessment — this is never assumed to be normal.
- Jaundice that lasts beyond 14 days (or 21 days if your baby was born early), or comes with pale stools or dark urine, needs urgent assessment for rarer, serious causes.
- A baby who is very sleepy, feeding poorly, very yellow, or unwell needs to be seen urgently — call 999 if your baby is hard to wake, floppy or struggling to breathe.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Finds out how high the bilirubin level really is, rather than guessing from how yellow the baby looks.
Judging jaundice by eye alone is not reliable, especially on brown and black skin, or in the first day of life — a measured level is needed.
The visual check and any skin-meter reading are immediate; the clinician will say if a blood test is needed.
Clear, written advice on what to watch for: colour, alertness, feeding, stool and urine colour.
The visual check and any skin-meter reading are immediate; the clinician will say if a blood test is needed.
A blood bilirubin level is usually back within hours, and a plan is made: watch and recheck, start phototherapy...
Light treatment usually lasts around a day or two, with the level checked during and after to confirm it is...
Specific tests are arranged to look for a cause; pale stools or dark urine make this urgent.
What is the assessment of newborn jaundice?
Jaundice is a yellow colouring of a baby's skin and the whites of the eyes. It is very common in the first days of life and is usually harmless, happening because a newborn's body is still learning to clear a substance called bilirubin. Most jaundice appears after the first day, peaks at around three to five days, and fades within about two weeks.
Assessing jaundice means checking how yellow the baby is and, when needed, measuring the bilirubin level — either with a light meter held against the skin (a transcutaneous bilirubinometer) or with a small blood test, usually a heel prick. The level, the baby's age in hours and how they are feeding decide whether simple watching, treatment, or further tests are needed.
The assessment matters because, although most jaundice is harmless, a few situations are not. Jaundice in the first 24 hours of life, a very high bilirubin level, or jaundice that lasts a long time can point to conditions that need attention. Very high bilirubin can, rarely, harm a baby's brain (kernicterus), which is why measuring and acting in good time is important.
This is an assessment, not a treatment in itself. Where treatment is needed, the usual first step is phototherapy (light treatment).
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Skin meter vs blood test
| Skin (light) meter | Blood test | |
|---|---|---|
| What it is | Device pressed on the skin | Small heel-prick sample |
| Speed | Immediate reading | Usually back the same day |
| Use | Screening check | Decisions about treatment |
| First 24 hours / high levels | Not relied on alone | Needed for accuracy |
The skin meter is a useful screen; a blood test is used to confirm and to guide treatment, especially early or at high levels.
Preparing for your test
- Keep your newborn's midwife, health visitor and GP contact details to hand, and don't hesitate to use them.
- Note when you first saw the yellow colour — especially if it was within the first 24 hours of life.
- Watch and note feeding: how often, how well, and how many wet and dirty nappies.
- Note the colour of your baby's stools (pale, cream or chalky is a concern) and urine (should be pale, not dark).
- Mention your blood group and any 'positive' antibody results from pregnancy if known.
- Say if your baby was born early, as the timeframes for prolonged jaundice differ.
- Trust your instincts — if your baby seems very yellow, very sleepy or is feeding poorly, ask for an urgent check rather than waiting.
What happens
A midwife, health visitor or doctor checks your baby in good light, pressing gently on the skin and looking at the whites of the eyes, gums and lips. They will ask about feeding, nappies, your baby's age in hours and the colour of stools and urine.
If needed, they measure the bilirubin level — first often with a skin meter for a quick estimate, and with a heel-prick blood test to confirm or when an accurate level is needed (for example in the first day of life or when the reading is high). The result is compared against a chart that takes account of your baby's age in hours and whether they were born early.
Depending on the level, your baby may simply be watched and rechecked, started on phototherapy (light treatment), or have further tests to look for a cause. If the bilirubin is very high, treatment is started quickly. You will be told the plan, what to watch for, and when the next check is.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Judging jaundice by eye alone is not reliable, especially on brown and black skin, or in the first day of life — a measured level is needed.
- A skin meter alone is not appropriate for decisions in the first 24 hours or at high levels — a blood test is required.
- A 'wait and see' approach is not appropriate for jaundice in the first 24 hours, prolonged jaundice, or pale stools/dark urine — these need proper assessment.
- Home 'remedies' such as sunlight are not a substitute for proper measurement and, if needed, phototherapy.
Alternatives to discuss
- Watchful waiting with rechecks for low-level jaundice in a well, feeding baby.
- A skin-meter screen rather than a blood test where the reading is clearly low.
- Feeding support, since improving feeding helps clear bilirubin.
- Phototherapy when the level crosses the treatment line.
- Specific tests for an underlying cause when jaundice is early, very high or prolonged.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Finds out how high the bilirubin level really is, rather than guessing from how yellow the baby looks.
- Identifies the small number of babies who need treatment, and starts it in good time.
- Picks up the rarer, serious causes signalled by early or prolonged jaundice, pale stools or dark urine.
- Reassures parents when jaundice is the common, harmless kind.
- Helps protect against the rare but serious risk of bilirubin harming the brain.
- Checks feeding and hydration, which affect jaundice and the baby's wellbeing.
Risks & complications
- A heel-prick blood test is briefly uncomfortable for the baby.
- Levels often need rechecking, meaning more than one test over a day or two.
- Skin-meter readings can over- or under-estimate, so a blood test is sometimes needed to be sure.
- A borderline result that needs repeating or watching, causing understandable worry.
- Admission for phototherapy if the level is high, separating you from home routines for a day or two.
- Further tests for a cause, which can take time to come back.
- A serious underlying cause (such as a blood group problem, infection, or a bile-drainage problem) found on testing.
- Very high bilirubin that, if not treated in time, can rarely harm the brain (kernicterus) — kernicterus is very rare in the UK.
- Rarely, the need for an exchange blood transfusion when bilirubin is dangerously high.
Three patterns always need urgent assessment rather than 'wait and see': jaundice that appears in the first 24 hours of life; jaundice that lasts beyond 14 days (21 days if born early); and pale, chalky stools or dark urine with jaundice. These can point to rare but serious causes. The main danger from very high bilirubin is harm to the brain, which is why timely measurement and treatment matter — but with proper checks this is very rare in the UK.
Published figures to discuss
Jaundice is extremely common in newborns and usually harmless; only a minority need treatment, and serious harm is rare in the UK because of routine checking. Exact rates depend on gestation, feeding, blood group and age in hours, so precise percentages for an individual baby are not given. The figure below is a well-established statement of how rare the most serious complication is.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Kernicterus (bilirubin harming the brain) | Very rare in the UK - fewer than about 1 in 100,000 babies | This rarity reflects routine checking and timely treatment; it is the reason measuring and acting on high levels matters, not a reason to ignore jaundice. | NHS — Newborn jaundicenhs.ukPublished figure |
| Jaundice in the first 24 hours | Always needs urgent assessment | Early jaundice is more likely to be pathological and should not be managed by watchful waiting. | Guide sourcesClinical context |
| Breastfeeding/feeding-related worsening | Recognised | Poor intake, weight loss or few wet nappies can raise bilirubin risk and need feeding support plus bilirubin measurement. | NHS — Newborn jaundicenhs.ukSource-linked context |
| Phototherapy side effects | Usually mild and manageable | Temperature, hydration, eye protection and repeat bilirubin checks are part of safe treatment. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no recovery from the assessment itself. 'Afterwards' means getting the bilirubin result, knowing the plan, and watching your baby's feeding, colour, stools and urine.
- Yellow colouring that is most noticeable around day three to five and usually fades by about two weeks.
- Needing the level rechecked once or twice to be sure it is falling.
- A short course of phototherapy for some babies, after which the level usually drops.
- Feeding well, with plenty of wet nappies and stools that become yellow (not pale).
Aftercare
- Feed your baby regularly and well; good feeding helps clear bilirubin — ask for feeding support if it is difficult.
- Keep an eye on the yellow colour, your baby's alertness and feeding, and the colour of stools and urine.
- Attend any recheck appointments so the level can be confirmed as falling.
- If phototherapy is advised, follow the team's guidance and keep to the planned checks.
- Seek urgent advice if your baby becomes more yellow, very sleepy, hard to wake, or feeds poorly.
- Report pale, chalky stools or dark urine straight away, at any age.
- For jaundice still present at 14 days (21 if born early), ask for the prolonged-jaundice check.
- Keep your midwife, health visitor and GP details handy and trust your instincts.
- Your midwife, health visitor and GP contact numbers
- A note of when the jaundice first appeared (especially if day one)
- A simple feeding and nappy record
- Awareness of stool colour (pale = concern) and urine colour (dark = concern)
- The date and place of any recheck
- Knowing the signs that mean urgent help (very sleepy, poor feeding, very yellow)
- A reminder to ask for the 14-day (or 21-day) check if jaundice persists
⚠ Get urgent help if…
- Jaundice (yellow skin or eyes) in the first 24 hours after birth — get urgent assessment; this is never assumed to be normal.
- A baby who is very sleepy and hard to wake, floppy, not feeding, or has a high-pitched cry — seek urgent help; call 999 if they are hard to rouse or struggling to breathe.
- Pale, cream or chalky stools, or dark yellow/brown urine, at any age — needs urgent assessment.
- Jaundice still present at 14 days of age (21 days if born early) — ask for the prolonged-jaundice check.
- Jaundice that is getting deeper, or spreading down the body to the legs.
- Signs of dehydration: few wet nappies, a dry mouth, or a sunken soft spot.
- Any fever, or a baby who simply seems unwell to you — trust your instincts and seek help.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A 'good result' is a bilirubin level below the treatment line for your baby's age, with your baby feeding and behaving normally — meaning the jaundice is the common, harmless kind that will fade. Where treatment is needed, a good result is the level falling safely with phototherapy.
A normal level on one day does not guarantee it will stay low, which is why rechecks are sometimes needed as jaundice can still rise in the first days. Equally, a measured level is far more reliable than judging by eye, especially on brown and black skin. The assessment tells you the level and the plan; it cannot, on its own, rule out every cause without the specific tests for early or prolonged jaundice.
Most newborn jaundice is a short-lived phase that fades within about two weeks as the baby's body matures. Once it has settled and any needed treatment is complete, it does not usually return. Jaundice that persists beyond 14 days (21 if born early) is a different situation that needs investigating for an underlying cause, rather than simply being watched.
Related tests, treatments or support
Where jaundice is early, high or prolonged, the assessment is often combined with other tests — blood group and antibody tests, a check for infection, thyroid and other blood tests, urine tests, and sometimes a scan of the liver and bile system — to look for a cause. Feeding support is frequently part of the picture, since feeding affects both jaundice and hydration.
Follow-up & long-term care
Follow-up depends on the level and the cause. Many babies just need a recheck to confirm the level is falling. Babies on phototherapy are monitored during and after treatment. For prolonged jaundice, a specific set of tests is arranged, and pale stools or dark urine make this urgent. You should always be able to get a re-check if you are worried.
Repeat, follow-on and what comes next
- Bilirubin levels are often rechecked over a day or two, as they can still rise early.
- A skin-meter reading may need confirming with a blood test.
- Some babies need a course of phototherapy, occasionally repeated if the level rebounds.
- Prolonged jaundice needs a specific set of tests rather than simply continued watching.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear, written advice on what to watch for: colour, alertness, feeding, stool and urine colour.
- A definite plan for rechecking the level and confirming it is falling.
- An around-the-clock contact and a low threshold for urgent review.
- A reminder and route for the prolonged-jaundice check at 14 days (21 if born early).
- Feeding support as part of the plan.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether a skin-meter reading alone is enough, or a blood test is needed.
- Whether further tests are needed to look for a cause (early, high or prolonged jaundice).
- Whether phototherapy or admission is required.
- Specialist (neonatal or paediatric) input if there is an underlying cause.
- Repeat tests to confirm the level is falling.
- Any feeding support involved.
- The fee for the assessment and any bilirubin testing (skin meter and/or blood test).
- The cost of further tests if a cause needs investigating.
- Whether phototherapy or admission would be covered and where it would happen.
- How repeat checks to confirm the level is falling are arranged and charged.
- Who to contact urgently, day or night, if the baby worsens.
- How an urgent transfer to NHS neonatal care would work if your baby needs it.
On the NHS? Checking and treating newborn jaundice is a core part of NHS newborn care; private testing exists, but any urgent concern about a newborn should go through your midwife, health visitor, GP or NHS services without delay.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being reassured by how yellow the baby 'looks' without a measured level when measurement is indicated.
- Jaundice in the first 24 hours not being treated as urgent.
- No clear advice about pale stools and dark urine and why they matter.
- Not being told to seek the 14-day (or 21-day) prolonged-jaundice check.
- No clear, around-the-clock route to urgent help if the baby becomes sleepy or feeds poorly.
Marketing red flags
- Offering home 'jaundice cures' or sunlight as an alternative to proper assessment.
- Reassuring parents without measuring bilirubin when measurement is needed.
- Downplaying early or prolonged jaundice as 'normal' without the right checks.
- Selling devices or supplements as a way to avoid medical assessment.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What is my baby's bilirubin level, and how does it compare with the treatment line for their age?
- Did the jaundice appear in the first 24 hours, and does that change what we need to do?
- Does my baby need treatment now, or watching and rechecking — and when is the next check?
- Are there any signs that make you want to test for a cause?
- What stool and urine colours should worry me, and what should I do if I see them?
- How is feeding, and can we get feeding support?
- Who do I contact urgently, day or night, if my baby becomes more yellow, very sleepy or feeds poorly?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is newborn jaundice dangerous?
Why does my baby need a blood test if a skin meter can measure it?
What is phototherapy?
My baby is still yellow at two weeks — does that matter?
Can I treat jaundice at home with sunlight?
Should I keep breastfeeding if my baby is jaundiced?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Newborn jaundice NICE CG98 — Jaundice in newborn babies under 28 days Bliss — Neonatal jaundice (information for parents) Great Ormond Street Hospital — Neonatal jaundice RCPCH — Newborn and neonatal care resources
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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