Take your baby to the emergency room now if they have jaundice and are hard to wake, will not feed, have trouble breathing, feel unusually floppy or stiff, have jerking movements, or have a temperature of 100.4°F (38°C) or higher. If yellowing begins in the first 24 hours after birth, seek urgent medical care immediately. For other new or worsening jaundice, contact your baby’s clinician the same day.
When should I take my baby to the ER for jaundice?
Newborn jaundice causes a yellow appearance in the skin or the whites of the eyes. It is common, and many babies improve without treatment. However, jaundice can sometimes be linked to a high level of bilirubin, a yellow substance that forms when red blood cells break down. Very high bilirubin levels can harm a baby's brain if they are not treated promptly.
According to the NHS, jaundice accompanied by certain changes in a baby's behavior or physical condition requires immediate medical attention. Go to the emergency department if your baby has jaundice along with any of the following warning signs:
- Difficulty waking: Your baby is much sleepier than usual, is difficult to rouse for feeds, or does not respond normally.
- Poor or absent feeding: Your baby will not breastfeed or take a bottle, or is too weak or sleepy to feed effectively.
- Abnormal muscle tone or movements: Your baby appears unusually floppy or stiff, has jerking or twitching movements, or arches their head and body backward.
- Breathing problems: Your baby is breathing very fast, struggling to breathe, grunting with each breath, or showing the skin pulling inward beneath the ribs.
- Abnormal body temperature: Your baby has a temperature of 100.4°F (38°C) or higher, or a low temperature of 96.8°F (36°C) or below.
- Very few or no wet diapers: Your baby is not producing urine, which may indicate a problem requiring urgent assessment.
- Unusual high-pitched or inconsolable crying: Your baby cries in a way that is markedly different from normal or cannot be soothed.
A baby who has yellow skin during the first 24 hours after birth also needs emergency assessment, even if they otherwise seem well. Do not wait for a routine newborn appointment. If your baby is unresponsive, having seizure-like movements, or struggling to breathe, call your local emergency number.
When should I call the pediatrician instead of going to the ER?
If your baby is older than 24 hours, looks yellow, is breathing normally, wakes for feeds, and behaves as usual, an emergency room visit may not always be necessary. However, you should contact your baby's pediatrician or another qualified healthcare professional the same day for an urgent assessment. Do not wait several days to see whether the yellow color disappears on its own.
The American Academy of Pediatrics advises parents to contact their baby's doctor when yellowing becomes more noticeable, spreads to the abdomen, arms, or legs, or affects the whites of the eyes. Feeding difficulties and unusual sleepiness also need prompt attention. A clinician can determine whether your baby needs a bilirubin test, closer monitoring, or treatment.
Seek prompt medical assessment as well if your baby's urine is dark yellow or brown, or their stools are unusually pale, cream-colored, white, or gray. These changes can sometimes be associated with problems involving the liver or the flow of bile. If any emergency warning sign develops, go to the ER rather than waiting for an outpatient appointment.
Does the baby's age make jaundice more concerning?
Yes. The timing of jaundice matters because bilirubin levels can change quickly during a newborn's first days of life. Ordinary newborn jaundice often becomes noticeable after the first day and is most apparent around the third day. Yellowing during the first 24 hours is unusual enough to require urgent emergency assessment rather than routine observation.
The Mayo Clinic explains that very high bilirubin levels can cause serious complications, including injury to the brain. Seek immediate help if jaundice occurs alongside difficulty waking, poor sucking, a high-pitched cry, backward arching, or fever. These signs may indicate a serious problem and should not be watched at home to see whether they improve.
Some babies also need closer follow-up because their risk of developing significant jaundice is higher. This includes babies born prematurely, babies with substantial bruising from delivery, babies with a known blood-group incompatibility, and babies who have feeding difficulties or a sibling who required treatment for jaundice. Tell the healthcare professional about these factors when arranging care, even if your baby appears relatively well.
How can you tell whether your baby's jaundice needs treatment?
You cannot reliably judge a baby's bilirubin level by the yellow color of their skin alone. Jaundice may be harder to notice in babies with darker skin, and the visible color does not show exactly how high the bilirubin level is. A baby who looks only slightly yellow may still need testing, while a yellow appearance does not automatically mean that hospital treatment is necessary.
MedlinePlus explains that healthcare professionals measure bilirubin using a device placed against the skin or a blood test. They interpret the result in relation to the baby's age, how the level is changing, whether the baby was born prematurely, and other relevant risk factors. If the level is too high, treatment may be needed promptly.
What happens if you take your baby to the ER for jaundice?
The medical team will assess your baby's alertness, feeding, temperature, breathing, hydration, and other signs of illness. They will ask when the yellow color first appeared, whether it has spread or become more noticeable, how often your baby feeds, and how many wet and dirty diapers they have had. They may also review your baby's birth history, previous bilirubin results, and any treatment already received.
A bilirubin measurement is often an important part of the assessment. Depending on the result and your baby's clinical condition, the team may recommend repeat testing, a period of observation, hospital admission, or treatment with phototherapy. Phototherapy uses a special light to help lower bilirubin levels. Babies with very high levels or signs of a serious complication may need more intensive treatment.
Not every baby with jaundice needs to stay in the hospital. The decision depends on the bilirubin level, the baby's age and health, feeding and hydration, and whether safe follow-up can be arranged. If your baby is sent home, follow the recommended plan for repeat bilirubin checks and clinical visits. Do not miss these appointments just because the yellow color appears to be improving.
What should you do while arranging medical care?
If your baby has any emergency warning sign, prioritize getting medical help rather than trying home measures first. For a baby who needs urgent assessment but has no emergency symptoms, contact the healthcare professional promptly and explain your baby's age, when the yellow color began, how feeding is going, and whether the symptoms are changing.
The Centers for Disease Control and Prevention (CDC) explains that regular feeding is important when managing newborn jaundice. During the first days of life, many babies need around 8 to 12 feeds in 24 hours. Continue offering breast milk or formula as appropriate, and ask for feeding support if your baby is not latching, sucking, or taking feeds well. Do not let feeding attempts delay emergency care.
Bring your baby's discharge paperwork, any previous bilirubin results, and a list of medicines they take, if available. Be ready to explain how many feeds and wet diapers your baby has had and whether their stools or urine have changed color. You do not need to collect all this information before seeking help if your baby is seriously unwell.
When is it safe to monitor jaundice at home?
Home monitoring should follow an assessment and a clear plan from your baby's healthcare professional. If your baby has been examined, their bilirubin level is below the treatment threshold, and follow-up is arranged, the clinician may recommend continued care at home. You should still attend every scheduled check because bilirubin levels can rise after an initial assessment.
Contact the healthcare professional again if the yellowing becomes more noticeable, feeding worsens, your baby develops new symptoms, or you are concerned that they are not producing enough wet diapers. Do not rely on photographs, skin color, or a brief period of apparent improvement to decide that testing is no longer needed. If emergency warning signs appear, seek emergency care immediately.
The key point: Jaundice does not always mean your baby needs the ER, but it should be assessed promptly. Go to the ER for jaundice with serious symptoms or when it appears in the first 24 hours after birth. For other new or worsening jaundice, contact your baby's healthcare professional the same day and follow their advice on testing and treatment.