HOW TO BATHE A BABY SAFELY: A STEP-BY-STEP GUIDE FOR NEW PARENTS

Seeing your newborn's skin turn yellow can be frightening, especially in the first days when you are still recovering and learning to feed your baby. The good news is that newborn jaundice is very common, and in most babies it is mild and goes away on its own. The important thing is to know what is normal, what to watch for, and when to call a doctor without waiting.

What is newborn jaundice?

Jaundice is a yellow colour of the skin and the whites of the eyes. It happens when there is too much bilirubin in the blood. Bilirubin is a yellow substance made when old red blood cells break down. It is a normal process at any age, but a newborn's liver is still learning how to remove bilirubin, so it can build up for a few days.

More than half of full-term babies, and even more premature babies, develop some jaundice in the first week of life.

Why does it happen?

• An immature liver: it cannot clear bilirubin quickly in the first days.
• More red blood cells: babies are born with extra red blood cells that break down quickly after birth.
• Low milk intake in the first days: the less a baby eats and passes stools, the less bilirubin leaves the body. This is why frequent feeding matters.

What is normal? A typical timeline

• First 24 hours: jaundice is not expected. If it appears now, contact a doctor or midwife immediately.
• Day 2 to 3: yellow colour usually starts to show, first on the face.
• Day 3 to 5: it is usually strongest.
• Around 2 weeks: it usually fades in full-term babies. Some breastfed babies stay a little yellow for longer.

Jaundice that lasts more than 2 weeks in a full-term baby, or more than 3 weeks in a premature baby, should always be checked by a doctor.

How to check your baby at home

1. Look at your baby in natural daylight. Artificial light can hide or change colours.
2. Gently press a finger on the forehead, nose, or chest, then release. If the skin looks yellow instead of returning to normal, jaundice may be present.
3. Check the whites of the eyes and the gums. This is especially useful for babies with darker skin, where the colour is harder to see on the skin.
4. Notice how far the yellow colour goes. Yellow only on the face is usually milder. Yellow on the belly, arms, or legs can mean a higher level and needs a medical check.

Warning signs: when to call the doctor right away

Contact your doctor, midwife, or emergency service without delay if your baby has any of these:

• Yellow colour in the first 24 hours after birth
• Yellow colour spreading to the belly, arms, or legs
• A baby who is very sleepy, hard to wake, or too tired to feed
• Poor feeding, or fewer wet diapers than expected (by about day 5, roughly six or more wet diapers a day)
• Pale, chalky, or clay-coloured stools, or very dark urine
• A fever, a high-pitched cry, or a baby who feels floppy or stiff

Do not wait to see if it improves when one of these signs is present.

Who is more likely to need treatment?

Some babies have a higher chance of high bilirubin levels:

• Babies born before 38 weeks
• Babies with a brother or sister who had jaundice that needed treatment
• Babies with a different blood group from their mother (for example, ABO or Rh incompatibility)
• Babies with a lot of bruising from birth
• Babies who are not feeding well or have lost a lot of weight
• Babies with certain inherited conditions, such as G6PD deficiency

This does not mean your baby will definitely need treatment. It means the medical team will watch more closely.

How is jaundice treated?

The doctor decides on treatment based on the bilirubin level, your baby's age in hours, and any risk factors. Levels can be checked with a skin scanner or a small blood test.

• Observation and feeding: for mild cases, extra feeds and follow-up checks are often enough.
• Phototherapy: your baby lies under a special blue light with eyes protected. The light changes bilirubin so the body can remove it. It is common, safe when done in hospital, and usually lasts one to a few days.
• Exchange transfusion: a rare treatment for very high levels, done only in hospital.

What helps at home, and what to avoid

What helps:

• Feed often: about 8 to 12 times in 24 hours if you are breastfeeding. Wake a very sleepy baby for feeds.
• Count wet and dirty diapers and write them down for your next check-up.
• Attend every follow-up visit, especially in the first days after leaving the hospital.

What to avoid:

• Do not rely on direct sunlight as a treatment. It is not a safe or reliable way to lower bilirubin, and it can burn a newborn's skin.
• Do not give water, sugar water, or herbal drinks. They fill your baby's stomach and can reduce milk intake.
• Do not stop breastfeeding unless a doctor specifically tells you to.

Frequently asked questions

Is jaundice dangerous?

Most jaundice is harmless. Very high bilirubin that is not treated can affect the brain, which is why warning signs must never be ignored.

Can I keep breastfeeding if my baby has jaundice?

Yes, in almost all cases. Frequent breastfeeding helps remove bilirubin. Ask for feeding support if latching is difficult.

Why is my breastfed baby yellow for longer?

Some breastfed babies stay mildly yellow for several weeks, often called breast milk jaundice. It is usually harmless, but a doctor should confirm there is no other cause, especially if it lasts past 2 weeks.

Will jaundice come back after it clears?

Usually not. If the yellow colour returns or your baby becomes sleepy or feeds poorly, contact your doctor.

Sources and further reading

• National Health Service (NHS), guidance on newborn jaundice: nhs.uk
• American Academy of Pediatrics, parent information on jaundice in newborns: healthychildren.org
• NICE guideline, Jaundice in newborn babies under 28 days: nice.org.uk

This article is for general education and does not replace advice from your doctor or midwife. If you are worried about your baby, contact a healthcare professional. See our Disclaimer.

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