Newborn Jaundice in Singapore

Written & reviewed by the BestDoctors.sg editorial team · Last updated 1 Sep 2026 · General information, not medical advice

Seeing your newborn turn yellow is common and usually nothing to fear – but a few specific patterns need prompt checking, which is exactly why babies are monitored so closely.

What it is

Jaundice is the yellow tint that appears when bilirubin builds up in a baby’s blood and tissues. Bilirubin is a natural yellow pigment made whenever red blood cells are broken down and recycled – something that happens continually in every one of us. A newborn produces bilirubin briskly and has a liver that is still learning to process and clear it, so a certain amount pools before the body catches up. As levels rise, the colour typically shows first in the face and the whites of the eyes, then works its way down the chest, tummy and, if it climbs further, the arms and legs. Pressing gently on the skin (over the nose or breastbone) can make a yellow tinge easier to see, especially in babies with deeper skin tones where it is harder to spot by eye alone.

For most babies this is a passing, harmless stage of early life rather than a sign that anything is wrong. It is described as physiological jaundice – the ordinary result of a newborn’s body settling into life outside the womb. A smaller number of babies develop jaundice for a more specific reason, or reach a level that needs treatment, which is why every newborn is watched during the first days and reviewed after going home.

Red flags – get urgent help

Most jaundice is mild, but some patterns are not. Seek urgent medical assessment – contact your doctor without delay or go to a children’s A&E (such as KKH or NUH) – if your baby:

• looks yellow within the first day of life (jaundice in the first 24 hours is always taken seriously);
• is becoming more deeply yellow, or the colour is spreading down to the arms and legs;
• is feeding poorly, not waking for feeds, or seems uninterested in the breast or bottle;
• is very sleepy or hard to wake, floppy, or unusually limp;
• has a high-pitched cry, or stiffens and arches the body backwards;
• has pale, chalky stools and dark urine (a warning sign for a liver or bile-duct problem);
• is passing fewer wet nappies than usual, or shows other signs of not getting enough milk.

Jaundice that first appears in the first day of life, that becomes very deep, or that lingers well beyond the usual settling-in period is not something to watch at home – it needs to be checked promptly. When in doubt, have your baby seen rather than wait.

Why it happens

The commonest reason is simply that a newborn’s liver is still maturing and cannot yet clear bilirubin as quickly as it is made. This ordinary, self-limiting jaundice needs no treatment in most babies.

Feeding-related patterns are also common. In the first days, a baby who is not yet taking much milk – while feeding is being established – may become more jaundiced because less bilirubin is being cleared through the stools; this usually settles as feeding improves. Separately, some breastfed babies stay mildly yellow for longer than others in a well, thriving baby, a pattern often called breast-milk jaundice; breastfeeding should generally continue, and a doctor can confirm all is well.

More significant causes exist and are the reason babies are monitored rather than assumed to be fine. These include blood-group incompatibility between mother and baby (such as ABO or Rhesus differences), which speeds up the breakdown of red cells; infection; being born premature, as an immature liver clears bilirubin more slowly; bruising from the delivery, since the pooled blood adds to the bilirubin load; and, importantly in this region, G6PD deficiency – an inherited condition, relatively common locally, in which red cells are more fragile and can break down faster. Occasionally a problem with the liver or bile ducts is the cause, which is why pale stools and dark urine are always flagged for review.

Normal versus concerning timing

Timing is one of the most useful clues, and it is a large part of what your care team is watching. Ordinary newborn jaundice tends to come on after the first day, peak over the following days, and then fade as the liver catches up and feeding gets going. That pattern in an otherwise well, feeding baby is reassuring.

Three patterns fall outside this and warrant urgent assessment. Jaundice that appears in the first 24 hours is never assumed to be ordinary and always needs checking. Jaundice that becomes very deep, or that keeps spreading down the body, needs a bilirubin measurement to guide whether treatment is required. And jaundice that is prolonged – lingering well beyond the usual settling-in window – should be reviewed, both to confirm the baby is thriving and to make sure a liver or bile-duct cause is not being missed, particularly if the stools are pale.

How it is checked and diagnosed

Checking for jaundice is part of routine newborn care. A doctor or nurse looks at the baby’s colour in good light and assesses how far it has spread. To measure the level, a painless handheld device can be pressed against the skin (a transcutaneous bilirubin reading), and where needed this is confirmed with a blood test. The result is interpreted against the baby’s age – because what counts as a safe level changes hour by hour in the early days – and plotted so the team can see whether it is rising, stable or falling.

If the level is significant or the pattern is unusual, further tests may look for an underlying cause – for example checking blood groups and for signs of red-cell breakdown, or looking for infection. In Singapore, all newborns are screened for G6PD deficiency as part of the national newborn screening programme, so affected babies are identified early and watched more closely. Because much of the first assessment happens in hospital and again at the post-discharge check, jaundice is usually picked up before it becomes a problem; your polyclinic, GP or paediatrician can also review a baby who looks more yellow at home.

Complications if very high and untreated

The reason jaundice is monitored so carefully is a rare but serious complication. If bilirubin climbs to a very high level and is not treated, it can cross into the brain and cause harm – a condition called kernicterus, which can lead to lasting problems. This is uncommon precisely because babies are checked, levels are measured, and treatment is started in good time when needed. Careful monitoring and prompt treatment are what keep the risk very low, which is why the red flags above matter and why deep or early jaundice is never left to run its course at home.

Treatment

Many babies need no treatment at all – just monitoring, good feeding and time, with the jaundice fading on its own. When the level is high enough to warrant it, the mainstay is phototherapy. The baby lies under a special blue light (with the eyes protected) that changes bilirubin in the skin into a form the body can pass out more easily in urine and stool. Phototherapy is generally straightforward and well tolerated; feeding continues, and levels are rechecked to confirm they are coming down.

Ensuring the baby is feeding well and staying hydrated is part of treatment in its own right, as this helps the body clear bilirubin. In severe cases that do not respond, or where the level is dangerously high, an exchange transfusion – replacing the baby’s blood in small amounts – may rarely be needed; this is done in hospital under close supervision. Where there is a specific cause, such as infection or blood-group incompatibility, that underlying condition is treated as well. One important caution: putting a baby in sunlight is not a safe or reliable treatment and can risk overheating or sunburn – it should never replace proper assessment and phototherapy.

Feeding and home care

Good feeding is the single most helpful thing parents can do. Frequent, effective feeds – whether breast or bottle – help a baby pass more stools and clear bilirubin, and support the wet-nappy count that signals enough milk is going in. If you are breastfeeding, it is usually best to keep going and feed often; a lactation adviser, nurse or doctor can help if latch or supply is a worry, and can advise rather than you stopping breastfeeding on your own.

At home, check your baby’s colour daily in natural light, including the whites of the eyes, and note whether the yellow is fading or spreading. Keep the scheduled newborn and post-discharge checks, as these are timed to catch rising jaundice. If your baby carries a G6PD deficiency result, follow the advice given about avoiding known triggers – such as mothballs and naphthalene, fava beans, and certain medicines and traditional remedies – and always tell any doctor or pharmacist about the diagnosis before a new medicine is given. HealthHub and your care team can point you to trusted local information.

When to see a doctor

Have your baby reviewed if the jaundice is deepening or spreading, if it appears very early or lasts longer than expected, or if you simply feel something is not right – a parent’s instinct is worth acting on. Your first ports of call are your polyclinic or GP, and your paediatrician, who can measure the bilirubin and decide whether treatment is needed. Seek urgent help – go to a children’s A&E such as KKH or NUH – for any of the red flags above: jaundice in the first day of life, a very deeply yellow baby, poor feeding, a baby who is very sleepy or hard to wake, floppy, high-pitched crying or arching, pale stools with dark urine, or fewer wet nappies. It is always better to have a jaundiced newborn checked than to wait and see.

Related children’s health topics

• Fever in children
• Colic in babies
• Constipation in children
• Bedwetting (enuresis)
• Eczema in children
• Food allergy in children
• Growing pains
• Speech & language delay
• Head lice
• Febrile seizures
• Hand, foot & mouth disease
• Paediatricians in Singapore
• Jaundice in Adults: Causes & What to Do (Singapore)
• Newborn Jaundice in Singapore: Causes, Phototherapy & Warning Signs
• Hirschsprung’s Disease
• G6PD Deficiency in Singapore: Triggers to Avoid & What It Means

Sources

• NUH / NUHS (Singapore) — newborn jaundice: prevalence, timeline, causes, bilirubinometer/blood test, phototherapy, red flags.
• NHS — newborn jaundice: onset, phototherapy, rare transfusion, urgent red flags (first day of life, unwell baby).
• College of Paediatrics & Child Health Singapore — neonatal jaundice management guideline.
• Newborn G6PD screening in Singapore — inherited cause, triggers to avoid, kernicterus prevention.