# Physiological Neonatal Jaundice - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources. · AAP Clinical Practice Guideline: Management of Hyperbilirubinemia in Newborn Infant 2022 - Verified date: 2026-08 ## Verified against - Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources. ## Treatment metadata - No drug therapy required ## Complete treatment card ```text PHYSIOLOGICAL NEONATAL JAUNDICE Sources: Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources. · AAP Clinical Practice Guideline: Management of Hyperbilirubinemia in Newborn Infant 2022 Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (9) - History: pregnancy problems, family history, the delivery, when symptoms began, how feeding is going, maternal serology - The colour of stool and urine hints at which type of jaundice [jaundice] - Yellowing showing up within the first 24 hours after birth is a major risk factor - A bilirubin already sitting in the high-risk zone before going home is a major risk factor - Blood group incompatibility between mother and baby, or a gestation <36 weeks - A close relative who needed phototherapy, cephalhaematoma or heavy bruising, exclusive breastfeeding, Asian origin [bruising] - Lesser risks: bilirubin in the high-intermediate band, a big baby of a diabetic mother, polycythaemia, male sex, mother over 25 - Look for bilirubin encephalopathy: feeding poorly, lethargy, disturbed sleep, abnormal tone, fits [kernicterus · lethargy · poor feeding · seizures] - Up to 15% of babies with kernicterus show nothing at all in the newborn weeks [kernicterus] SIGNS - what you find (4) - Examine in daylight, but judging it by eye is unreliable, more so after phototherapy or with dark skin - Confirm any jaundice that matters with a serum or transcutaneous bilirubin [jaundice] - Pointers to a pathological cause: pallor, petechiae, cephalhaematoma, heavy bruising, big liver and spleen, weight loss, dehydration [bruising · dehydration · pallor · petechiae · weight loss] - Yellow skin and whites of the eyes in a newborn is jaundice [jaundice] TESTS (12) - Every newborn should be looked at for jaundice every 12 hours until discharge - Measure bilirubin between 24 and 48 hours of age, or before discharge if the baby leaves sooner - Transcutaneous bilirubin screens and spares blood tests, but is less use with dark skin or after phototherapy - Send a serum bilirubin once the transcutaneous reading passes the 95th percentile on its nomogram, or 75% of the phototherapy threshold - Transcutaneous testing cannot read the direct fraction, so it cannot diagnose cholestasis - For haemolysis: mother and baby blood groups, direct antibody test, blood count, reticulocytes, film, G6PD - Imaging is usually unnecessary for unconjugated hyperbilirubinaemia - With conjugated bilirubin, transaminases show liver cell damage, and a raised ALP or GGT points to blocked bile ducts - PT, INR and albumin gauge how well the liver is working - Liver ultrasound finds sludge in the bile ducts, stones, thickened bile and choledochal cysts - A triangular cord sign on ultrasound is close to 100% specific for biliary atresia - Further tests: TORCH titres, urine and viral cultures, newborn screening, metabolic disease, alpha-1 antitrypsin phenotype, genetics IF NOT THIS - what else fits (4) - Jaundice appearing needs prompt sorting into a self-limiting physiological one or a disease needing treatment - Carotene from breast milk or carotene-rich food yellows the skin of older infants and can pass for jaundice - In carotenaemia the whites of the eyes and the mucosa stay clear, and no newborn is born with it - Cholestasis in a newborn usually touches several systems, which steers the workup Source StatPearls "Neonatal Jaundice" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY REQUIRED [1st line] Adult None - supportive care only x 7-10 days Peds Encourage frequent breastfeeding every 2-3 hours (8-12 feeds/24h). Monitor transcutaneous or serum bilirubin Source Neonatal Jaundice - StatPearls (NCBI Bookshelf NBK532930) - https://www.ncbi.nlm.nih.gov/books/NBK532930/, which describes physiologic jaundice as "mild, transient, and self-limiting", recommends "frequent, on-demand feeding", and states that "supplemental oral water and dextrose water are not recommended". The 8-12 feeds per 24 hours figure is the AAP 2022 guideline's, already listed in this condition's sources. Why Frequent breastfeeding (8-12 times daily) is the primary intervention for physiological neonatal jaundice; no drug therapy required Caution Routine IV fluids not indicated; encourage frequent breastfeeding (8-12 feeds/24h) and monitor bilirubin. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)