Jaundice and the Breastfed Infant

What is jaundice?

Jaundice is a condition that causes your baby’s skin to turn yellow in the first few days after birth. You may also notice that the sclera (white parts) of the baby’s eyes are yellow.

The yellow color of the skin and sclera in newborns with jaundice comes from a build up of bilirubin. Small to medium increases in bilirubin are normal in newborns and will not hurt your baby.

Very high levels of bilirubin can cause hearing loss, seizures and brain damage.

Signs that bilirubin may be at a harmful level

  • Yellow coloring of the skin, starting on the face and moving down the body
  • Poor feeding
  • Increased sleepiness

If your baby has jaundice, it is important that bilirubin levels are monitored closely. If your baby does not drink enough milk, this can lead to increased bilirubin. You should see a lactation consultant to get help with breastfeeding.

Two key factors  

  • How much milk you are making?
  • How much milk can your baby take from the breast?

Tips to help prevent jaundice in your baby

  • Initiate breastfeeding as soon after birth as possible — preferably within one hour.
  • Early, frequent, unrestricted breastfeeding helps to eliminate bilirubin from baby's body. Bilirubin exits the body in the infant's stools, and because your milk has a laxative effect, breastfeeding frequently will result in lots of soiled diapers and thus, lower bilirubin levels. Your newborn should breastfeed a minimum of eight times per day.
  • Be sure that your baby is latched on well and is sucking efficiently. Seek assistance from a lactation consultant if there are any concerns your baby is not latching well.

What to do if your baby becomes jaundiced

  • Provide frequent, unrestricted breastfeeding.
  • Jaundice sometimes makes babies sleepy, so they breastfeed less enthusiastically. Waking your baby every two to three hours to feed is recommended.
  • If your breasts still feel full after breastfeeding, pump or express your breasts. In addition, pumping after breastfeeding will help stimulate your milk production.
  • Your baby’s healthcare provider may recommend supplementing your baby with bottles of expressed milk or formula in conjunction with breastfeeding.
  • Some babies require phototherapy. Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. If your baby requires phototherapy, it is important to maximize the amount of time spent under the lights while still breastfeeding frequently.
  • Seek the advice of a lactation consultant to assist you.

Reviewed by Diane L. Spatz, PhD, RN-BC, FAAN on August 01, 2012