Spotting Neonatal Cholestasis Early: A Q&A With Dr. Pamela Valentino

Good News: Research Shows Jaundice In Newborns Can Be Safely Treated At Home

Key Points

New research shows jaundice treatment at home is safe and effective

Severe jaundice can result in permanent brain damage

Parents should immediately report to their GP if their child passes a white stool

Neonatal paediatrician Dr Rajesh Maheshwari says about 70 per cent of newborns develop jaundice within first week, irrespective of gender, race, and parents' nationalities. "Severe jaundice can result in permanent brain damage," Dr Maheshwari told SBS. "But the good news is it is safe and effective to treat jaundice at home.

"However, if jaundice appears within first 24 hours, it is definitely abnormal and is not suitable for home based therapy at least in the initial phase," Dr Maheshwari added.

Neonatal paediatrician Dr Rajesh Maheshwari. (Supplied by Dr Rajesh Maheshwari)

The traditional approach had been to treat jaundice in newborns at hospitals using phototherapy and other methods, resulting in delayed discharge for babies. But for the past few years, Sydney midwives have been providing phototherapy at homes through midwifery-led home care as mothers and their newborns now spend less time at hospitals post-birth. "Delayed discharge or readmission is still routine in many hospitals," according to a Western Sydney Local Health District (WSLHD) news .

"At Westmead Hospital, however, safe early discharge is possible with midwives undertaking jaundice surveillance and treatment at home as part of routine early postnatal care for mothers and babies."

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Dr Maheshwari was part of the Westmead Hospital team that analysed data of 4,300 children born in 2019. "We found that midwifery-led home care was quite effective in managing jaundice cases. The treatment provided at home is as successful as the hospital treatment," Dr Maheshwari said.

"Parents found it convenient as they don't have to go to the hospital, and the hospital also saved resources," he added.

Dr Maheshwari, however, emphasised strict monitoring and proper decisions based on the baby's condition and medical history. "In some cases, babies with jaundice may need hospital treatment, but overall, the home-based approach has proven beneficial and safe," he said. Dr Maheshwari advised against exposing children to the sun. "Sun therapy is neither safe nor effective. The sun in Australia is harsher, and we don't want to expose children to ultraviolet rays," he said. Dr Maheshwari said jaundice should resolve in two weeks for full-term babies (those born after 37 weeks) and three weeks in pre-term babies. "Parents should immediately report to their doctor if their child passes a white stool," he added. Tune into at 5 pm every day and follow us on and

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Bringing Your Newborn Baby Home - What To Expect

Day 1 at home with your newborn

Batten down the hatches. "Try to keep visitors to a minimum for the first few days as you find your feet as a family. If your baby sleeps a lot today, don't panic - catch up on some well-earned rest because you 'll feel incredibly tired," says Sue Jacob, midwife teacher at the Royal College of Midwives.

"Use the answering machine amd call people back once you're ready to talk," says Katie, 33, mum to Jasmine, 8, Maisie, 5 and Libby, 1.

Also, prepare for bleeding, which can last up to six weeks. "Expect to bleed quite heavily at first, especially when you move around. Gradually it'll change from bright to darker red or brown, and any clots will disappear," says Michelle Lyne, a midwifery advisor for the Nursing & Midwifery Council.

"Stock up on maternity pads before you give birth. Normal pads aren't designed for women who have just given birth – you'll need more than that," says Megan, 36, mum to Anna, 10 months.

Singing songs or playing music can help soothe your 3 week old newborn.

Day 2 at home with your newborn

The midwife will call in today so expect to be examined down below if you've had stitches there. "She'll examine your breasts, your uterus (by feeling your tummy), your bleeding and stitches, and then check your baby's weight, muscle tone (strength), skin for jaundice or rashes, umbilical cord stump, fontanelles (soft spots) on her head, and her mouth for things like thrush," explains Sue. She'll also discuss your emotions and how your baby's feeding and sleeping.

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You may also notice that your baby's poos are changing from a sticky greeny-black substance to a more watery yellow colour. Don't worry, this is all normal.

Chances are you'll wake up with swollen breasts today as this is around the time when your milk supply comes in. "The best solution is to put your baby to your breast to relieve the pressure," says Sue. If you're not able to breastfeed, take paracetamol to help any pain, and the swelling will subside in a few days when your milk supply dries up.

When your baby takes her first breathes of air, her heart and circulation will become completely mature. Because her bowels are full of meconium, the first poo she does after birth will be sticky and greenish-black.

Day 3 at home with your newborn

You may be thinking about giving your baby a bath, but for the first week or so, a gentle wipe with cotton wool and cooled boiled water will do. Use the damp cotton wool to clean ears, eyes, face, neck, hands, the base of the umbilical cord and the nappy area.

If you've had stitches, the pain should be easing by now, and don't panic if your stomach isn't as flat as you'd like - your uterus needs time to contract.

You may feel exhausted after being up all night with your newborn, but there are some simple tricks you can try to hide your fatigue.

Day 4 at home with your newborn

Some of the initial euphoria may have worn off leaving you feeling quite low. "Don't worry, this is completely normal," says Sue. "Sometimes a good cry helps, but if the feelings don't go away, talk to your midwife."

Your baby will be awake more now. "Cope with tiredness by napping when the baby naps," says Sue.

You may feel ready for visitors but aim to keep any visits short to start with and try to time visits for when your baby's awake.

What to expect when it's time to take your newborn home

Day 5 at home with your newborn

Midwife visit number two happens towards the end of the week. She'll do checks, including a 'heel prick' test (taking a sample of blood from your baby's heel to screen for conditions including sickle cell disorders and cystic fibrosis.) "The needle prick doesn't really hurt but we recommend feeding afterwards to help soothe your baby," says Michelle.

Your baby will be weighed again today, and is likely to have lost a little weight. "It's OK for a baby to lose up to 10% of her birth weight. It'll soon pick up," reassures Sue.

If you've had a caesarean, you may have your stitches removed today.

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Day 6 at home with your newborn

If you're feeling up to it, why not go for a short walk to the park, or somewhere green, with your baby? You could even register the birth (by law you have to do this within 42 days).

"Blood loss should be changing colour by now," says Michelle. "It should be a darker red or brown with fewer clots, but it still increases when you move around."

"You may feel you're getting into the swing of things, but still accept all offers of help," Sue recommends.

Day 7 at home with your newborn

You've made it! It won't be long (usually 10 to 21 days after birth) before your baby's umbilical cord stump starts to shrivel. "Keep an eye on it," says Michelle. "If it starts bleeding, mention it to the midwife. Otherwise, just wipe around the base with cooled boiled water and cotton wool."

You've only been a mum for just over a week so don't expect to be 'perfect'. "Don't try to be superwoman," says Sue. "It's OK to relax in your PJs and nap when you can!"

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