The pale yellow discolouration of jaundice usually starts to appear on the baby's face and neck and the whites of their eyes. This happens about 24 to 48 hours after the birth. As the levels of bilirubin accumulate, the yellow colouring deepens and 'moves' down the baby's body (over a day or two) to their chest, belly, and sometimes upper arms and legs. The levels peak at around 3 to 6 days after the birth. (If the bilirubin levels become very high, the jaundice can be seen right down to the baby's hands and feet.)
Image 11-09 illustrates a baby with jaundice. The baby's face has a yellow colouring, compared to his hand and arm.
After a week or so, the bilirubin levels start to lower and the yellow discolouration disappears 'in reverse'. That is, the baby's chest, neck head and eyes are the last areas to lose their yellow appearance.
Most jaundice is mild to moderate with the yellow discolouration being mainly confined to the baby's head, neck, chest, belly areas, possibly to their upper arms and thighs. The baby usually remains well and healthy and feeds normally. If the jaundice becomes severe (moving down to their feet and hands), the baby may show signs of being drowsy, lethargic and reluctant or disinterested in feeding. Most babies will have treatment commenced before they reach this stage.