[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Neonatal jaundice [Conditions](https://durgical.com/en/conditions/) · [Metabolism: heme, bilirubin and iron](https://durgical.com/en/conditions/) # Neonatal jaundice Yellow colouring of a newborn from high bilirubin; it is nearly always mild and temporary, but very high levels can damage the brain. Updated 2026-11-01 ## Structures involved Tap one to see what it is and open it in 3D. - [Liver](https://durgical.com/en/anatomy/liver/) - [Skin](https://durgical.com/en/anatomy/skin/) - [Sclera](https://durgical.com/en/anatomy/sclera/) - [Globus pallidus](https://durgical.com/en/anatomy/globus-pallidus/) - [Spleen](https://durgical.com/en/anatomy/spleen/) ## In biochemistry - [Heme breakdown and bilirubin: Step 5 · Colonic bacterial β-glucuronidases and reductases](https://durgical.com/en/biochemistry/pathways/heme-breakdown-and-bilirubin/#paso-5) - [Heme oxygenase](https://durgical.com/en/biochemistry/enzymes/heme-oxygenase/) - [Biliverdin reductase](https://durgical.com/en/biochemistry/enzymes/biliverdin-reductase/) - [UGT1A1 (bilirubin UDP-glucuronosyltransferase)](https://durgical.com/en/biochemistry/enzymes/ugt1a1/) - [Bilirubin](https://durgical.com/en/biochemistry/molecules/bilirubin/) - [Albumin](https://durgical.com/en/biochemistry/enzymes/albumin/) - [Xenobiotic biotransformation: phases I, II and III](https://durgical.com/en/biochemistry/topics/xenobiotic-biotransformation-phases-i-ii-and-iii/) - [Glucuronidation](https://durgical.com/en/biochemistry/topics/glucuronidation/) ## In immunology - [Type II hypersensitivity (antibody against cells)](https://durgical.com/en/immunology/type-ii-hypersensitivity/) - [ABO and Rh blood groups, hemolytic disease of the newborn](https://durgical.com/en/immunology/abo-and-rh-blood-groups-hemolytic-disease-of-the-newborn/) - [Neonatal immunity: maternal IgG and breast-milk IgA](https://durgical.com/en/immunology/neonatal-immunity-maternal-igg-and-breast-milk-iga/) - [Passive immunization: immunoglobulins and antitoxins](https://durgical.com/en/immunology/passive-immunization-immunoglobulins-and-antitoxins/) - [Direct and indirect Coombs test](https://durgical.com/en/immunology/direct-and-indirect-coombs-test/) ## In embryology - [Biliary atresia](https://durgical.com/en/embryology/biliary-atresia/) - [Tetracyclines and aminoglycosides](https://durgical.com/en/embryology/tetracyclines-and-aminoglycosides/) ## In the clinical exam - [Pallor, cyanosis and jaundice](https://durgical.com/en/clinical-exam/pallor-cyanosis-and-jaundice/) - [Pediatric history: perinatal, growth, development and vaccines](https://durgical.com/en/clinical-exam/pediatric-history-perinatal-growth-development-and-vaccines/) - [Jaundice: prehepatic, hepatic and posthepatic](https://durgical.com/en/clinical-exam/jaundice-prehepatic-hepatic-and-posthepatic/) ## In physiology - [Blood groups, transfusion and transfusion reactions](https://durgical.com/en/physiology/blood-groups-transfusion-and-transfusion-reactions/) - [The red cell life cycle and the spleen](https://durgical.com/en/physiology/the-red-cell-life-cycle-and-the-spleen/) - [Rh incompatibility](https://durgical.com/en/physiology/rh-incompatibility/) - [Bile and the enterohepatic circulation](https://durgical.com/en/physiology/bile-and-the-enterohepatic-circulation/) - [Newborn physiology and fetal maturation](https://durgical.com/en/physiology/newborn-physiology-and-fetal-maturation/) ## Why it happens - [Fetal hydrops: immune and nonimmune](https://durgical.com/en/general-pathology/fetal-hydrops-immune-and-nonimmune/) - [Pigments in tissue: lipofuscin, hemosiderin, melanin, bilirubin, carbon](https://durgical.com/en/general-pathology/pigments-in-tissue-lipofuscin-hemosiderin-melanin-bilirubin-carbon/) ## What it is Hyperbilirubinemia of the newborn, usually unconjugated; it may be physiological or pathological (hemolysis, infection, cholestasis). ## Who gets it About 60 % of term newborns and over 80 % of preterm infants have it. In Colombia it is one of the most frequent causes of neonatal readmission; blood-group incompatibility and G6PD deficiency are important causes of severe cases. ## Causes - Physiological: more short-lived red cells, immature UGT1A1 and more enterohepatic circulation - From insufficient breastfeeding (first week) and from breast milk (after the first week) - Hemolysis: ABO or Rh incompatibility, G6PD deficiency, spherocytosis - Cholestasis (conjugated bilirubin): biliary atresia, infections, hypothyroidism ## Risk factors - Prematurity - Breastfeeding with poor intake and weight loss - A sibling who needed phototherapy - Cephalohematoma or bruising - Mother blood group O or Rh negative ## Pathophysiology The newborn makes more bilirubin (larger red-cell mass, red cells living about 80–90 days) and conjugates less (immature UGT1A1). The nearly bacteria-free gut and mucosal β-glucuronidase return bilirubin to the blood. Excess free bilirubin crosses the blood–brain barrier and damages the basal ganglia and auditory nuclei. ## Classification - Physiological: appears after 24 hours, peaks at 3–5 days - Pathological: within 24 hours, rises fast, lasts over 2 weeks or is conjugated ## Symptoms and signs - Yellow colour that spreads from the face to the trunk and legs - Yellow sclerae - Drowsiness and weak sucking when high ## Red flags - Jaundice in the first 24 hours of life - Pale stools and dark urine (possible biliary atresia) - High-pitched cry, hypertonia, arching or fever (acute encephalopathy) - Jaundice lasting more than 2 weeks ## Diagnosis **Clinical** Visual assessment in good light before discharge and at early follow-up; visual estimation alone is not reliable. **Tests** Transcutaneous or total serum bilirubin, read against hours of life and risk factors on a nomogram; direct bilirubin; blood group and direct Coombs; blood count with reticulocytes; G6PD. **Imaging** Biliary ultrasound if jaundice is conjugated; brain MRI if kernicterus is suspected. ## Treatment **Conservative** Breastfeeding support and frequent feeding to increase stool clearance **Procedure** Blue-light phototherapy when bilirubin exceeds the threshold for its age in hours **Acute** Exchange transfusion for very high levels or signs of encephalopathy **Medical** Intravenous immunoglobulin in immune hemolysis not responding to phototherapy **Surgical** Early portoenterostomy (Kasai) if biliary atresia is present ## Complications - Acute bilirubin encephalopathy - Kernicterus: cerebral palsy, deafness, gaze abnormalities and dental enamel defects ## Prognosis Excellent in physiological jaundice; kernicterus is preventable with timely detection and treatment. ## Prevention - Measuring bilirubin before discharge and follow-up within 48–72 hours - Prenatal blood grouping and anti-D immunoprophylaxis ## Test yourself Think of the answer, then tap the question to see it. ## Why are newborns prone to jaundice? They make more bilirubin, have immature UGT1A1 and more enterohepatic circulation. ## Which neonatal jaundice is always pathological by its timing? Jaundice that appears in the first 24 hours of life. ## What do jaundice, pale stools and dark urine suggest? Cholestasis, such as biliary atresia, which needs urgent investigation. ## How does phototherapy work? Blue light turns bilirubin into soluble isomers that are excreted without conjugation. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/neonatal-jaundice/) ## Related conditions - [Crigler-Najjar syndrome](https://durgical.com/en/conditions/crigler-najjar-syndrome/) - [Gilbert syndrome](https://durgical.com/en/conditions/gilbert-syndrome/) - [Sickle cell disease](https://durgical.com/en/conditions/sickle-cell-disease/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Newborn jaundice: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001559.htm) (MedlinePlus, US National Library of Medicine, 2026); [Bilirubin blood test: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003479.htm) (MedlinePlus, US National Library of Medicine, 2026); [Jaundice | Icterus | MedlinePlus](https://medlineplus.gov/jaundice.html) (MedlinePlus, US National Library of Medicine, 2026). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/neonatal-jaundice/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/neonatal-jaundice/