Here we talk about the possible signs, like prolonged jaundice and persistently pale baby poo. Plus we give you a guide to this rare condition.
While liver disease in babies is rare, early diagnosis can save lives. So it’s important to be aware of the signs, they are:
- prolonged jaundice – yellowing of the skin and the whites of the eyes
- persistently pale-coloured baby poo
- yellow or dark yellow wee – a newborn baby’s wee should be colourless.
(CLDF, 2021a)
What is prolonged jaundice?
Jaundice is a common condition in newborn babies and it’s usually harmless. It causes yellowed skin and eyes (NHS, 2022). Find out more here in our article about newborn jaundice.
Jaundice is described as prolonged jaundice if your baby still has it 14 days after they were born. If your baby was born prematurely, their jaundice is prolonged if they have it after day 21 (NHS, 2022).
Why do some babies stay jaundiced?
A number of different things can mean your baby’s jaundice continues. Prolonged jaundice could be caused by:
- your baby being born early. Jaundice in premature babies can take up to three weeks to go away.
- a condition that makes blood cells break down more quickly than normal. Your healthcare professional will often recognise this condition during your pregnancy or soon after your baby’s birth.
- breastfeeding – occasionally, babies who are completely well and are being breastfed can experience jaundice for longer. No need to stop breastfeeding though – the jaundice will fade with time and will not cause any ill effects.
- an infection or some other illness.
- their thyroid gland not working properly. The Guthrie blood test – the heel-prick test, which all babies have between five and eight days old – will usually detect this.
- rarely, a liver problem.
(CLDF, 2021b)
What is liver disease in babies?
On the rare occasions that an underlying health condition is the cause of newborn jaundice, the jaundice often develops in the baby’s first 24 hours (NHS, 2022).
Babies can have various different childhood liver conditions and problems that are called liver disease (CLDF, 2021c).
What should I do if my baby’s jaundice is not getting better?
If your baby’s jaundice is not getting better or you are concerned about your baby’s health, contact your GP as soon as possible.
The colour of your baby’s poo and wee can give you an indication of whether there might be problems (CLDF, 2021b). Check out your baby’s poo colour against the Children’s Liver Disease Foundation’s handy chart.
Baby poos should be:
- green or daffodil yellow coloured if you breastfeed your baby.
- green or English mustard coloured if you bottle-feed your baby.
(CLDF, 2021b)
Your baby’s poos should not be:
- pale or chalky.
(CLDF, 2021b)
Newborn baby wee should be colourless. If your baby’s wee is yellow and/or the poo is pale or chalky, this can indicate liver disease and you will want to report this to your midwife, health visitor or GP (NICE, 2016; CLDF, 2021b).
Do not wait to see whether your baby’s jaundice goes after they’re 14 days old if you notice abnormal coloured poo or wee before then (CLDF, 2021b).
What is the split bilirubin blood test?
If your baby has prolonged jaundice, it’s important to talk to your GP and ask for a split bilirubin blood test. The split bilirubin test checks your baby’s blood for the ratio of conjugated and unconjugated bilirubin. This test will help to check whether your baby’s jaundice is caused by an underlying condition like liver disease (CLDF, 2021b; Lab Tests Online, 2021).
From the results of the split bilirubin test, if your baby has:
- high levels of unconjugated bilirubin, they might need treatment because it can, although very rarely does, cause damage to your baby’s brain (kernicterus).
- conjugated bilirubin levels higher than 20% of the total bilirubin, this indicates liver disease. Your baby will be referred to a specialist paediatric liver unit for more tests.
(CLDF, 2021b; Lab Tests Online, 2021; NHS, 2022)
This page was last reviewed in March 2022.
Further information
Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.
You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
NHS Choices and the Children’s Liver Disease Foundation (0121 212 3839) have more information about newborn jaundice and liver disease in babies.
The Children’s Liver Disease Foundation is dedicated to fighting all forms of childhood liver disease. Their Yellow Alert campaign promotes the early diagnosis of liver disease in newborns.
For support with breastfeeding, see our article Breastfeeding support and its comprehensive list of support groups, phone lines, websites and videos.
Bliss is a special care baby charity that offers a wide range of services to support parents and families of babies born premature or sick. The Bliss support line: 0808 801 0322.
CLDF (Children’s Liver Disease Foundation). (2021a) Yellow alert. Available at: https://childliverdisease.org/healthcare-professionals/yellow-alert/ [Accessed 15th March 2022]
CLDF (Children’s Liver Disease Foundation). (2021b) Baby jaundice. Available at: https://childliverdisease.org/liver-information/baby-jaundice/ [Accessed 15th March 2022]
CLDF (Children’s Liver Disease Foundation). (2021c) Childhood liver conditions. Available at: https://childliverdisease.org/liver-information/childhood-liver-conditi… [Accessed 15th March 2022]
Lab Tests Online. (2021) Bilirubin. Available at: https://labtestsonline.org.uk/tests/bilirubin [Accessed 15th March 2022]
NHS. (2022) Newborn jaundice. Available at: https://www.nhs.uk/conditions/jaundice-newborn/ [Accessed 15th March 2022]
NICE. (2016) Jaundice in newborn babies under 28 days. Available at: https://www.nice.org.uk/guidance/CG98 [Accessed 15th March 2022]
