Why does neonatal jaundice recur?

Written by Li Jiao Yan
Neonatology
Updated on April 14, 2025
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Neonatal jaundice is one of the most common conditions in newborns, especially in early-born infants. If a baby has jaundice, it is important to determine whether it is physiological or pathological jaundice. If it is physiological, the jaundice will not appear too early or be too severe, and will gradually subside on its own within a certain period, typically without recurrence. If the jaundice decreases or has already subsided and then reoccurs, be vigilant for pathological jaundice. The causes of pathological jaundice are numerous and depend on the increase in bilirubin. If direct bilirubin is elevated, liver and biliary diseases should be suspected. If indirect bilirubin is elevated, it may indicate pathological factors causing destruction of red blood cells, leading to an increase in jaundice. Therefore, if there is recurring jaundice, it is advisable to seek timely medical attention at the hospital.

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Written by Li Jiao Yan
Neonatology
1min 3sec home-news-image

Is a bilirubin level of 20 high for a newborn?

If a newborn's skin jaundice reaches a level of twenty, it is a warning sign that the jaundice is significantly elevated. It is advised to promptly go to the hospital for an examination. If the bilirubin levels in the blood are indeed that high, timely intervention and treatment are necessary. Normally, for physiological jaundice, the levels should not exceed fifteen after seventy-two hours in infants. Even during the peak period of four to five days, it should not surpass fifteen. If the jaundice noticeably increases within the first three days and exceeds twenty, the severity of the jaundice might be worse. The younger the newborn, especially with levels above twenty, the higher the risk of bilirubin entering the brain, potentially leading to bilirubin encephalopathy. Therefore, with jaundice reaching twenty, it is still recommended to promptly go to the hospital for intervention and treatment.

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Written by Li Jiao Yan
Neonatology
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What is considered high for neonatal jaundice?

Neonatal jaundice is common during the neonatal period and can be divided into physiological jaundice and pathological jaundice. Physiological jaundice does not require intervention or treatment, and the baby's condition is generally okay. For physiological jaundice, the bilirubin level typically does not exceed 6 within the first 24 hours after birth, then not exceeding 9 from 24 to 48 hours, not exceeding 12 from 48 to 72 hours, and not exceeding 15 after 72 hours. If the monitored bilirubin levels exceed these ranges, there may be pathological jaundice, indicating abnormally high levels.

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Written by Yao Li Qin
Pediatrics
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Neonatal jaundice is divided into several types.

Neonatal jaundice, also known as neonatal hyperbilirubinemia, occurs when bilirubin accumulates in the body, causing yellowing of the skin or other organs; it is the most common clinical issue during the neonatal period, with over 80% of normal newborns experiencing some skin yellowing shortly after birth. Neonatal jaundice is mainly divided into physiological jaundice and pathological jaundice. Physiological jaundice is a normal phenomenon. Pathological jaundice, however, includes conditions such as excessive production of bilirubin, metabolic disorders of bilirubin, bile excretion disorders, and various other factors causing pathological jaundice. Thus, pathological jaundice requires active treatment and will not subside on its own.

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Written by Li Jiao Yan
Neonatology
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neonatal jaundice subsidence time

Neonatal jaundice is a common phenomenon and a unique condition in newborns. If it is normal physiological jaundice, it generally subsides within two weeks for full-term infants born after 37 weeks. This means that after two weeks, the jaundice is essentially gone; the skin and eyes are no longer yellow, and bilirubin levels are typically below 6-7, which is considered normal. For premature infants, the jaundice generally clears within four weeks. If the jaundice persists longer, there might be some pathological factors involved, and it is advisable to visit a hospital for a thorough evaluation by a doctor to determine if any special treatment is needed.

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Written by Yao Li Qin
Pediatrics
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Does neonatal jaundice require medication?

Neonatal jaundice is divided into physiological jaundice and pathological jaundice. Physiological jaundice appears two to three days after birth, peaks around the fifth or sixth day, and then gradually subsides, so there is no need for medication in this case. If it is neonatal pathological jaundice, merely taking medication does not solve the problem; this requires treatment with blue light therapy. At the same time, it is important to identify the cause of the jaundice and treat it accordingly. In such cases, medication is actually not necessary. Therefore, it is crucial to first determine whether neonatal jaundice is physiological or pathological. Physiological jaundice requires no intervention, while pathological jaundice necessitates hospital treatment. Regarding the increasingly common breastfeeding jaundice, medication is generally not needed; monitoring of the jaundice in the child is essential, however. If the jaundice level continues to rise and exceeds 15 mg/dl, blue light therapy is also required. If the condition is not severe, exposing the child to more sunlight and waiting for the jaundice to subside naturally is sufficient.