Kuning bayi (newborn jaundice) is a common condition that turns a baby's skin and eyes yellow; it is usually harmless and goes away within about 2 weeks. It happens because a newborn's liver cannot yet clear bilirubin properly. Feeding your baby often (8 to 12 times a day) helps, and if the bilirubin reading (bacaan kuning bayi) reaches the treatment level, phototherapy is the safe and effective treatment. Do not put your baby in the sun: Malaysian guidelines say it may cause dehydration and sunburn. Jaundice in the first 24 hours, a very sleepy or poorly feeding baby, or yellow spreading to the legs and soles needs urgent medical attention.
What is kuning bayi (newborn jaundice)?
According to the NHS, jaundice in babies (newborn jaundice) is a common condition that causes yellowing of the skin and eyes. It is usually harmless and gets better without treatment.
It usually happens because a newborn baby's liver is not able to work fully straight away, so a yellow waste product called bilirubin builds up in the blood. After a few weeks, the liver develops fully and bilirubin levels return to normal. For most babies, the yellow is most noticeable at around 3 days old, and it usually takes around 2 weeks to go.
Most jaundice is mild, but bilirubin levels still need to be checked: Malaysian clinical guidelines note that untreated severe jaundice may lead to deafness and brain damage.
How do you check your baby for jaundice?
Malaysian guidelines advise parents to look for jaundice daily during the first week of life. To check:
- look at your baby undressed in bright, preferably natural light;
- press gently on the skin of the chest (or the tip of the nose or forehead) with a finger, then release: yellow skin is easier to see after pressing;
- check the whites of the eyes, and under the tongue or inside the cheeks;
- remember that yellow can be harder to see on brown or black skin.
Jaundice usually starts on the face and head and spreads down the body as the level rises. Health workers use this pattern (called Kramer's rule) as a rough screening guide:
| Where the yellow reaches | Approximate bilirubin range |
|---|---|
| Head and neck | 4–8 mg/dL (68–133 µmol/L) |
| Upper body, above the belly button | 5–12 mg/dL (85–204 µmol/L) |
| Lower body and thighs, below the belly button | 8–16 mg/dL (136–272 µmol/L) |
| Arms and lower legs | 11–18 mg/dL (187–306 µmol/L) |
| Palms and soles | 18 mg/dL (306 µmol/L) or more |
This is only a rough guide. Any jaundice needs to be confirmed by a healthcare provider, usually with a skin meter or a blood test, which measures bilirubin accurately.
Bacaan kuning bayi: what do bilirubin readings mean?
Bilirubin results (bacaan kuning bayi) can be given in either mg/dL or µmol/L (1 mg/dL is about 17 µmol/L). There is no single "normal" number: whether a reading needs treatment depends on
- your baby's age in hours (levels naturally rise in the first days);
- how many weeks of pregnancy the baby was born at;
- risk factors such as G6PD deficiency, blood group problems (isoimmune haemolytic disease), infection (sepsis) or a lack of oxygen at birth (asphyxia).
For babies born at 35 weeks or later, Malaysian clinical practice guidelines use these levels to start conventional phototherapy:
| Baby's age | Low risk: 38 weeks or more and well | Medium risk: 38 weeks or more with risk factors, or 35–37 weeks and well | High risk: 35–37 weeks with risk factors |
|---|---|---|---|
| Under 24 hours | Any jaundice is abnormal and needs evaluation | Any jaundice is abnormal and needs evaluation | Any jaundice is abnormal and needs evaluation |
| 24 hours | 9 mg/dL (154 µmol/L) | 7 mg/dL (120 µmol/L) | 5 mg/dL (86 µmol/L) |
| 48 hours | 12 mg/dL (205 µmol/L) | 10 mg/dL (171 µmol/L) | 8 mg/dL (137 µmol/L) |
| 72 hours | 15 mg/dL (257 µmol/L) | 12 mg/dL (205 µmol/L) | 10 mg/dL (171 µmol/L) |
| 96 hours | 17 mg/dL (291 µmol/L) | 14 mg/dL (239 µmol/L) | 11 mg/dL (188 µmol/L) |
| Over 96 hours | 18 mg/dL (308 µmol/L) | 15 mg/dL (257 µmol/L) | 12 mg/dL (205 µmol/L) |
Important: this table is for understanding only. Thresholds are lower for premature and low birth weight babies, much higher levels may need an exchange transfusion, and a fast-rising level also matters. Your baby's doctor will interpret the result together with the full picture; do not use this table to decide on treatment yourself.
When is kuning bayi dangerous?
According to Malaysian guidelines, jaundice in the first 24 hours of life is abnormal and needs urgent review, and jaundice in the first 48 hours also needs urgent review by a healthcare provider. Babies should be referred to hospital if jaundice extends below the belly button or to the soles of the feet, if bilirubin is rising fast, if they have G6PD deficiency and were not already admitted, or if there are signs of infection.
Get emergency help (call 999 or go to the emergency department), according to the NHS, if your baby has jaundice and:
- is sleepier than normal or difficult to wake;
- is not feeding;
- is floppy or stiff, or has jerking or twitching movements;
- has a temperature of 38°C or more, or 36°C or less, feels hot or cold, or is shivering (see our guide to demam and body temperature);
- has not had any wet nappies;
- has difficulty breathing, is breathless or breathing very fast;
- is less than 24 hours old.
See a doctor urgently if your baby is over 24 hours old and you think they have jaundice, the jaundice is not improving or is getting worse, or their pee is dark yellow or brown or their poo is pale and creamy (keep a sample of poo to show the doctor).
What causes newborn jaundice, and who is at higher risk?
Most newborn jaundice is caused by the baby's immature liver and is not a sign of another health condition. According to the NHS, other causes include an inherited condition called Gilbert's syndrome, infections, the baby having a different blood type from the mother, and problems with how the liver works.
Malaysian guidelines list these risk factors for severe jaundice:
- being born early (premature) or with a low birth weight;
- jaundice in the first 24 hours of life;
- a mother with blood group O or rhesus negative;
- G6PD deficiency;
- a rapid rise in bilirubin;
- infection (sepsis);
- not getting enough breast milk, or a high bilirubin level before going home;
- a large bruise or swelling on the head from birth;
- a mother with diabetes;
- a brother or sister who had severe jaundice.
G6PD deficiency is one of the risk factors for severe jaundice. In Malaysia, all babies should be screened for G6PD deficiency at birth. Babies who are G6PD deficient should be admitted and monitored for jaundice during the first 5 days of life, or followed up closely if they went home earlier.
Cara turunkan kuning bayi: what actually helps?
Most babies with jaundice get better without treatment. What helps, according to the NHS and Malaysian guidelines:
- Feed often: around 8 to 12 times a day helps babies get better more quickly. If your baby is sleepy, wake them for feeds.
- Continue breastfeeding, even if your baby is jaundiced. Ask your nurse, midwife or doctor for help if feeding is difficult or you are not sure your baby is getting enough.
- If a breastfed baby is not getting enough milk, is dehydrated or has lost more than 10% of their birth weight, extra expressed breast milk or formula may be considered. Babies who have lost more than 7% of their birth weight should be checked and closely monitored for jaundice.
- Phototherapy: if bilirubin reaches the treatment level, the baby lies under a special light shone on the skin. It is safe and effective. It is usually done in hospital, sometimes at home, and most babies need around 48 hours.
- Rarely, babies with very high levels need an exchange transfusion or medicine through a vein in hospital.
Babies who had severe jaundice may need a hearing test and follow-up afterwards.
Should you put your baby in the sun (jemur bayi)?
No. Putting a baby in the sun (jemur bayi) is sometimes suggested as a home remedy, but Malaysian clinical guidelines say that exposing the baby to sunlight as a treatment may be harmful because of dehydration and sunburn. They also state that traditional and alternative methods of treating jaundice are unproven and likely to be ineffective.
Natural daylight is useful for checking your baby's skin colour, but not for treatment. If you are worried about jaundice, get your baby's bilirubin checked at a klinik kesihatan or hospital rather than trying home remedies.
What if jaundice lasts more than 2 weeks?
According to Malaysian guidelines, if jaundice lasts beyond 14 days in a baby born at full term, or beyond 21 days in a premature baby, further checks for prolonged jaundice are needed. According to the NHS, if jaundice could be caused by something serious, such as an infection or liver problems, tests can include blood and urine tests and an ultrasound scan of the liver.
Pale, creamy poo or dark yellow or brown pee at any age is a reason to see a doctor urgently. If you are still preparing for the birth, see also our guide to tanda bersalin.
Frequently asked questions (FAQ)
What is kuning bayi (newborn jaundice)?
Kuning bayi, or newborn jaundice, is a common condition that makes a baby's skin and the whites of the eyes look yellow. It happens because a newborn's liver cannot yet clear a yellow substance called bilirubin properly. It is usually harmless and gets better without treatment, often within about 2 weeks, but levels need to be checked because very high bilirubin that is not treated can cause deafness and brain damage.
What is a normal bacaan kuning bayi (bilirubin reading)?
There is no single normal number. Whether a bilirubin reading needs treatment depends on your baby's age in hours, how many weeks pregnant you were at birth, and risk factors such as G6PD deficiency. For example, in Malaysian guidelines for well babies born at 38 weeks or more, phototherapy starts at about 9 mg/dL (154 µmol/L) at 24 hours of age, 12 mg/dL (205 µmol/L) at 48 hours and 15 mg/dL (257 µmol/L) at 72 hours, and lower for babies at higher risk. Your doctor will interpret your baby's result.
How can I bring down my baby's jaundice (cara turunkan kuning bayi)?
Feed your baby often, around 8 to 12 times a day, and wake a sleepy baby for feeds. Continue breastfeeding. If your baby is not feeding well or has lost a lot of weight, your doctor may suggest extra expressed breast milk or formula. If bilirubin reaches the treatment level, the effective treatment is phototherapy, a special light given in hospital or sometimes at home.
Should I put my baby in the sun for jaundice?
No. Malaysian clinical guidelines say that exposing a baby to sunlight as a treatment for jaundice may be harmful because of dehydration and sunburn, and that traditional and alternative remedies are unproven and likely to be ineffective. Phototherapy is the safe and effective treatment. Bright natural light is useful only for checking your baby's skin colour, not for treatment.
When is newborn jaundice dangerous?
Jaundice in the first 24 hours of life is not normal and needs urgent medical review. Get emergency help if a baby with jaundice is very sleepy or hard to wake, not feeding, floppy or stiff, has jerking movements, has a high or low temperature, has no wet nappies or has difficulty breathing. Also see a doctor urgently if the yellow is spreading to the legs, palms or soles, is getting worse, or the baby's poo is pale or pee is dark.
Can I keep breastfeeding if my baby has jaundice?
Yes. Malaysian guidelines advise continuing breastfeeding even if your baby is jaundiced, because of its benefits. Ask your nurse, midwife or doctor for help with breastfeeding if needed. If your baby is not getting enough milk, is dehydrated or has lost more than 10% of their birth weight, supplementation with expressed breast milk or formula may be considered.
How long does newborn jaundice last?
For most babies, the yellow colour is most noticeable at around 3 days old and usually goes within about 2 weeks. If jaundice lasts beyond 14 days in a baby born at full term, or beyond 21 days in a premature baby, it needs further checks for prolonged jaundice.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor, nurse or midwife. Bilirubin thresholds shown are for understanding only; always follow your baby's healthcare team. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
