Causes of neonatal jaundice

Written by Zhang Xian Hua
Pediatrics
Updated on April 09, 2025
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Neonatal jaundice is relatively common and its causes are usually related to the characteristics of neonatal bilirubin metabolism, which are mainly manifested in the following aspects: First, excessive production of bilirubin; second, poor ability of plasma albumin to bind bilirubin; third, poor ability of liver cells to process bilirubin; fourth, the enterohepatic circulation is more prevalent than in adults, thus making physiological jaundice more likely to occur. Furthermore, some children are affected by breastfeeding, with a portion of breastfed babies experiencing breast milk jaundice. Other factors include pathological reasons, such as viral infections common in hepatotropic viruses like cytomegalovirus, TORCH, etc.; jaundice can also occur following exposure to cold, which can lead to decreased resistance and bacterial infections; additionally, some children have jaundice due to genetic metabolic reasons.

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Written by Li Jiao Yan
Neonatology
1min 6sec home-news-image

Do newborns with jaundice love to sleep?

In newborns with jaundice, it is important to determine whether it is physiological or pathological jaundice. Typically, babies with normal physiological jaundice are generally in good condition, able to eat and sleep well. If they are hungry or uncomfortable, they will cry and wake up. However, if a baby continuously sleeps without waking up for a long period of time, does not wake up even when stimulated, it might indicate a condition of excessive sleepiness, which then falls into a pathological state. If the jaundice significantly worsens and affects the brain, it is often referred to as bilirubin encephalopathy, which might initially manifest as excessive sleepiness. Severe infections or other diseases can also present excessive sleepiness as a symptom. Therefore, if you notice that the baby is sleeping significantly more than usual, and appears lethargic and unresponsive, it is advisable to seek medical attention promptly.

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Written by Li Jiao Yan
Neonatology
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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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Where to test for neonatal jaundice

Neonatal jaundice is one of the common symptoms during the newborn period. Generally, jaundice is monitored in hospitals after the baby is born. If the baby is discharged, jaundice still needs to be monitored. Normal physiological jaundice usually peaks around four to five days and subsides around ten days. If the baby's jaundice is higher than usual after discharge, more frequent monitoring is required. It is generally recommended that jaundice monitoring can be done at local community centers, maternal and child health hospitals, or people's hospitals with obstetrics and gynecology departments, where jaundice can typically be measured. The main test for jaundice is through transcutaneous bilirubin measurement. If the transcutaneous bilirubin measurement is high, it is necessary to confirm whether the bilirubin in the blood is high, which would require going to the hospital for a blood test and liver function test to determine the severity of the jaundice.

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Written by Li Jiao Yan
Neonatology
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Does neonatal jaundice recede from the forehead first?

Neonatal jaundice is one of the most common phenomena in newborns, with about 80% of full-term infants visibly exhibiting jaundice. Typically, the development of jaundice begins in the facial area and gradually extends to the trunk and limbs. Its reduction follows the reverse pattern, generally receding from the limbs to the trunk and then slowly to the facial area. Usually, if the face no longer appears yellow, the jaundice has essentially subsided.

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Written by Li Jiao Yan
Neonatology
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Will newborn jaundice cause the ears to turn yellow?

Neonatal jaundice is one of the common symptoms in neonates, especially in early newborns. It can be a symptom of normal development in newborns, or it can be a manifestation of certain diseases. Jaundice is generally divided into physiological jaundice and pathological jaundice, with the main symptom being the yellowing of the skin and mucous membranes. Typically, jaundice starts from the face and then spreads to the trunk and limbs. If the degree of jaundice is relatively severe, yellowing will appear on the entire body, including the ears. Generally, if the baby is visibly yellow, it is advisable to monitor the jaundice. If the jaundice value is significantly high and confirmed to be high in the blood, it is considered pathological jaundice, and it is recommended to seek timely intervention and treatment.