Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow.

Many healthy babies have some jaundice during the first week of life. It usually goes away. However, jaundice can happen at any age and may be a sign of a problem. Jaundice can happen for many reasons, such as

• Blood diseases
• Genetic syndromes
• Liver diseases, such as hepatitis or cirrhosis
• Blockage of bile ducts
• Infections
• Medicines

Some babies have a yellowish tint to their skin or the whites of their eyes right after birth. This is called jaundice. It can happen to adults, too. For adults, it can be a sign of a serious health condition.

Your liver helps rid your body of natural waste products and other harmful substances. If something interferes with this process, toxic compounds can build up in your body.

Jaundice happens when you have too much of a compound called bilirubin. Bilirubin forms when your body breaks down old or damaged red blood cells. The most common symptom is a yellow tint to your skin, the whites of your eyes, or the inside of your mouth. You may also have dark urine or pale stools.

Babies become jaundiced when their livers can’t break down all the bilirubin that is produced the first few days after birth. Jaundice in babies usually goes away on its own in a week or two. If it goes on longer than this, they should be evaluated by a doctor.

In adults, many health conditions can lead to jaundice. One of the more common causes is when bile ducts get blocked. Bile ducts drain bilirubin from the liver into the intestines. They can get blocked by hard, pebble-like pieces of material that form in the gallbladder, called gallstones. Gallstones are usually made of bilirubin or cholesterol (a waxy, fat-like substance). Cancers of the bile duct or pancreas can also cause a blockage.

Jaundice can also be a sign of liver disease. Some liver diseases are caused by drinking too much alcohol or taking drugs. Others are caused by too much fat buildup in the liver.

Misusing certain medications, like acetaminophen, can damage the liver and lead to jaundice. So can hepatitis, or inflammation of the liver. Viruses are the most common cause of hepatitis. But the condition can be caused by other things, like toxins and certain diseases.

If a liver disease lasts for only a short time, the liver may be able to heal. But if the disease becomes chronic, meaning it lasts for a long time, it can lead to scarring of the liver. This scarring is called cirrhosis. Cirrhosis can impair the liver’s ability to function and may eventually lead to liver failure.

Not everyone who has jaundice has a serious health condition. Some people are born with a condition called Gilbert syndrome. This condition slows the liver’s ability to break down bilirubin. It can lead to short periods of high bilirubin levels and, sometimes, jaundice. But it doesn’t lead to further complications and doesn’t need special treatment.

If you have any symptoms of jaundice, see a health care provider right away. “Your provider will need to do liver tests to figure out what type of jaundice it is,” says Dr. David Goldberg, a liver specialist at the University of Miami Health System.

Treatment depends on the cause. Gallstones are most commonly treated with surgery to remove the gallbladder. Liver damage that’s caused by medications will often heal once you stop taking the medication. Antiviral drugs can treat hepatitis virus infections. People with a chronic liver disease should limit alcohol use to prevent further liver damage.

Goldberg is one of several NIH-funded researchers studying whether cholesterol-lowering drugs called statins can slow or prevent the progression of liver disease.

You can take steps to protect yourself from things that damage the liver. See the Wise Choices box for tips on keeping your liver healthy.

Take Care of Your Liver

• Eat a healthy diet and maintain a healthy weight.
• Take steps to prevent hepatitis infections. Get vaccinated against hepatitis A and B. Always wash your hands after using the toilet, changing diapers, and before and after handling or preparing food. Learn more about viral hepatitis.
• Limit alcohol use. Drinking too much alcohol harms the liver.
• Quit smoking. You can get free help quitting at 1-800-QUIT-NOW or smokefree.gov.
• Take medications only as directed.
• Tell your provider about all the medicines you take, including over-the-counter drugs and supplements.

About 60% of all babies have jaundice. Some babies are more likely to have severe jaundice and higher bilirubin levels than others. Babies with any of the following risk factors need close monitoring and early jaundice manage­ment:

Preterm Babies

Babies born before 37 weeks, or 8.5 months, of pregnancy might have jaundice because their liver is not fully developed. The young liver might not be able to get rid of so much bilirubin.

Babies with Darker Skin Color

Jaundice may be missed or not recognized in a baby with darker skin color. Checking the gums and inner lips may detect jaundice. If there is any doubt, a bilirubin test should be done.

East Asian or Mediterranean Descent

A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. Also, some families inherit conditions (such as G6PD deficiency), and their babies are more likely to get jaundice.

Feeding Difficulties

A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice.

Sibling with Jaundice

A baby with a sister or brother that had jaundice is more likely to develop jaundice.

Bruising

A baby with bruises at birth is more likely to get jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to look black and blue. The healing of large bruises can cause high levels of bilirubin and your baby might get jaundice.

Blood Type

Women with an O blood type or Rh negative blood factor might have babies with higher bilirubin levels. A mother with Rh incompatibility should be given Rhogam.

Jaundice usually appears first on the face and then moves to the chest, belly, arms, and legs as bilirubin levels get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. The baby’s doctor or nurse can test how much bilirubin is in the baby’s blood.

See your baby’s doctor the same day if your baby:

• Is very yellow or orange (skin color changes start from the head and spread to the toes).
• Is hard to wake up or will not sleep at all.
• Is not breastfeeding or sucking from a bottle well.
• Is very fussy.
• Does not have enough wet or dirty diapers (at least 4-6 thoroughly wet diapers in 24 hours and 3 to 4 stools per day by the fourth day).

Get emergency medical help if your baby:

• Is crying inconsolably or with a high pitch.
• Is arched like a bow (the head or neck and heels are bent backward and the body forward).
• Has a stiff, limp, or floppy body.
• Has strange eye movements.

At a minimum, babies should be checked for jaundice every 8 to 12 hours in the first 48 hours of life. It is important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5 days old, because this is usually when a baby’s bilirubin level is highest. This is why, if your baby is discharged before age 72 hours, your baby should be seen within 2 days of discharge. The timing of this visit may vary depending on your baby’s age when released from the hospital and other factors.

A doctor or nurse may check the baby’s bilirubin using a light meter that is placed on the baby’s head. This results in a transcutaneous bilirubin (TcB) level. If it is high, a blood test will likely be ordered.

The best way to accurately measure bilirubin is with a small blood sample from the baby’s heel. This results in a total serum bilirubin (TSB) level. If the level is high, based upon the baby’s age in hours and other risk factors, treatment will likely follow. Repeat blood samples will also likely be taken to ensure that the TSB decreases with the prescribed treatment.

No baby should develop brain damage from untreated jaundice.

When being treated for high bilirubin levels, the baby will be undressed and put under special lights. The lights will not hurt the baby. This can be done in the hospital or even at home. The baby’s milk intake may also need to be increased. In some cases, if the baby has very high bilirubin levels, the doctor will do a blood exchange transfusion. Jaundice is generally treated before brain damage is a concern.

Putting the baby in sunlight is not recommended as a safe way of treating jaundice.