# 20. How to care for a newborn baby This section focuses on two main topics: what it takes to keep a newborn alive and how much it will cost you. Only differences that are substantial and backed by solid evidence are included here. Detailed advice on soothing or raising a baby is beyond the scope of this book. For tasks to handle before birth and on the day of discharge, please refer to Section 27. ### 1. Keep infants sleeping on their backs on a firm surface; share a room but not a bed; and do not place any soft items in the crib or bed - Cost: This costs nothing upfront. However, you’ll need to replace the mattress with a firm one, which may cost several hundred yuan. The real challenge is resisting pressure from older relatives to deviate from this rule. - In plain terms: Always place babies on their backs to sleep on a hard, flat surface. Parents and infants should share a room, but not the same bed. Never put pillows, blankets, bed rails, stuffed animals, or special shaped pillows in the sleeping area. Inclined cribs or baby chairs are only meant for sitting — they must never be used as a sleeping surface. In the United States alone, roughly 3,500 infants die each year from sleep-related causes. - Benefit: Each year, nearly 3,500 infants in the U.S. lose their lives to sleep-related issues, including sudden infant death syndrome, deaths of unknown cause, and accidental suffocation in bedding. The American Academy of Pediatrics recommends a safe sleep environment consisting of: infants sleeping on their backs; using a solid, non-inclined sleeping surface; sharing a room without sharing a bed; and avoiding soft bedding and overheating. Additional protective measures include breastfeeding, keeping infants away from nicotine and alcohol, ensuring all vaccinations are up to date, and offering a pacifier during sleep. - Evidence grade: A - Sources:Moon RY, Carlin RF, Hand I, Task Force on Sudden Infant Death Syndrome and the Committee on Fetus and Newborn (2022). Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 150(1), e2022057990. - Notes: “Do not place any soft items in the bed” means absolutely no pillows, blankets, bed rails, stuffed toys, or shaped pillows — even nursing pillows that appear perfectly safe are prohibited. Inclined cribs and baby chairs must never be used as sleeping areas. This requirement represents the biggest departure from common practice in this section, and it often requires the strongest resistance to family pressure. ### 2. Administer the first dose of hepatitis B vaccine within 24 hours after birth - Cost: No cost at all. The hepatitis B vaccine is part of the routine immunization program, so it is provided free of charge. It is given to newborns in the hospital on the day of birth; no extra trips are needed. - In plain terms: The first dose of hepatitis B vaccine must be given to a newborn within 24 hours after birth. Roughly 95% of infants and toddlers who contract hepatitis B go on to develop chronic hepatitis. In contrast, the vast majority of adults who get infected recover on their own without medical intervention. Hence, the earlier this vaccine is administered, the greater its protective benefit. If the mother tests positive for hepatitis B surface antigen, the infant also needs to receive an injection of hepatitis B immunoglobulin at the same time. - Benefit: The World Health Organization states: “All infants should receive the hepatitis B vaccine as early as possible after birth, ideally within 24 hours.” The rationale behind this recommendation is that “about 95% of infections in infants and toddlers progress to chronic hepatitis.” Most adults who contract the virus also recover spontaneously, meaning they do not require any treatment to get better. - Evidence grade: A - Sources:World Health Organization. Hepatitis B fact sheet. - Notes: If the mother tests positive for hepatitis B surface antigen, the newborn must receive an injection of hepatitis B immunoglobulin right after birth. This fact must be clarified during prenatal checkups; do not wait until after delivery to ask about it. Details on screening requirements for mothers can be found in Section 1. ### 3. Ensure your child receives all vaccines in the national immunization schedule at no cost; missed doses can be added later - Cost: Absolutely free. Laws explicitly state that vaccination centers may not charge any fees for administering vaccines on the national schedule. You’ll need to visit the clinic several times according to your child’s age. Be sure to keep the vaccination record safe and never lose it. - In plain terms: All vaccines included in the national immunization schedule are completely free — clinics cannot charge a single cent. Both daycare centers and schools require proof of vaccination, so any missed doses will definitely be noticed and must be made up later. You only need to receive the remaining doses; there’s no need to restart the entire series from the beginning. Even if a different manufacturer produces the same vaccine, it can still be used. Conditions such as eczema, hives, allergic rhinitis, asthma, and even neonatal jaundice do not prevent vaccination, provided the condition remains stable. - Benefit: Daycare centers and schools must verify that children have received all required vaccines on schedule. If any gaps are found, they must inform vaccination centers so guardians can be urged to complete the missing doses. Thus, missing vaccines cannot be ignored — they must be addressed before school entry. The current guidelines date to 2026. Human papillomavirus (HPV) vaccine is now part of the national schedule. The starting age for DTaP vaccination has been lowered from 3 months to 2 months; a total of five doses are required at 2, 4, 6 months, 18 months, and age 6. Starting March 2026, children in Tibet, Qinghai, Xinjiang, and the Xinjiang Production and Construction Corps will also routinely receive Japanese encephalitis vaccine. Multiple vaccines may be administered on the same day per current protocols, provided they are injected into separate sites; mixing different vaccines into one syringe is strictly prohibited. For inactivated vaccines, oral live vaccines, and other types, no minimum interval is required between doses. For children under 18, the rule is to catch up as soon as possible — only the missing doses must be given, not the whole series from scratch. Switching manufacturers poses no problem. (National guidelines, 2026 edition) - Evidence grade: A - Sources:全国人大常委会 (2019). 疫苗管理法（第四十八、四十九条）. （云南省卫生健康委员会转载）；国家疾病预防控制局、国家卫生健康委 (2026). 《国家免疫规划疫苗儿童免疫程序及说明（2026 年版）》解读问答. - Notes: A common misconception is that children with weaker health should delay vaccination. In reality, having an “allergic constitution,” a family history of allergies, or prior food or drug allergies does not constitute a barrier to vaccination. Conditions such as atopic dermatitis (eczema), hives, allergic rhinitis, and bronchial asthma can all be managed safely provided they remain under control. Children taking antihistamines or inhaled corticosteroids may also be vaccinated. Physiological or breast milk–related neonatal jaundice poses no issue either. The only true contraindications are prior occurrence of acute severe allergic reactions to a specific vaccine or known hypersensitivity to any component of that vaccine. Children with immune deficiencies, undergoing chemotherapy or radiotherapy, or on immunosuppressive therapy require individualized assessment by a medical professional prior to vaccination. For details on the first dose of hepatitis B vaccine, refer to section 2. Non‑schedule vaccines sold at additional cost are unrelated to this free program. ### 4. Breastfeed exclusively for the first 6 months — no water needed; introduce solids at 6 months while continuing breastfeeding - Cost: This costs nothing; it even saves money compared to formula. The main “cost” is time — breastfeeding takes up a lot of daily effort. The real challenge is maintaining this routine; breastfeeding must continue without interruption during the first 6 months. - In plain terms: Breastfeeding should begin within the first hour after birth. For the first 6 months, infants only need breast milk — no water or other fluids are required. At 6 months, solid foods can be introduced, while breastfeeding should be continued until age 2 or beyond. These solid foods must include iron-rich animal-based products. If breast milk is insufficient or unavailable, formula is a perfectly acceptable alternative — there is no need to feel guilty. The choice between breast milk and formula has far less impact on a child’s survival than ensuring they sleep on their back. - Benefit: The World Health Organization recommends initiating breastfeeding within the first hour after birth. It also advises exclusive breastfeeding for the first 6 months — meaning no other foods or liquids, not even water — followed by the gradual introduction of safe, adequate solid foods while continuing breastfeeding until at least age 2. The national Health Commission’s guidelines likewise promote exclusive breastfeeding from birth to 6 months, and further stipulate that solid foods given after 6 months must contain iron-rich animal products. - Evidence grade: A - Sources:World Health Organization. Breastfeeding. ；国家卫生健康委办公厅 (2024). 婴幼儿营养喂养评估服务指南（试行）（国卫办妇幼函〔2024〕452 号）. - Notes: If breast milk is insufficient or not an option, formula is a perfectly acceptable substitute — there is no need for guilt. The difference between breastfeeding and formula feeding is far smaller than the impact of ensuring safe sleeping practices. As for frequency of solid food intake: infants aged 6–8 months should consume solids 1–2 times daily, while those aged 9–12 months should have 2–3 servings per day. Their daily diet must include at least four of the seven essential food groups. For infants with severe eczema or egg allergies, the question of whether to avoid peanuts is addressed in Section 12 of this chapter — the answer is: there is no need to avoid peanuts. ### 5. Use water hotter than 70 °C to prepare formula, then let it cool before feeding; discard any leftovers - Cost: No monetary cost. It only requires a few extra minutes of waiting for the milk to cool. The difficulty lies in the fact that even when a baby is crying from hunger, caregivers must still wait for the water temperature to drop before mixing the formula. - In plain terms: Formula milk is not sterile and may contain a bacterium called Cronobacter sakazakii. Once newborns are infected, reported mortality rates range from 40% to 80%. To minimize this risk, first pour hot water into the feeding bottle, then wait until the temperature drops to around 73.8 °C before adding the formula. At this point, the milk remains above 70 °C, which can reduce the amount of this bacterium to less than one ten-thousandth of its original level. After preparation, let the milk cool completely before feeding, and discard any portions that are not consumed. - Benefit: Formula milk is not sterile and may harbor Cronobacter sakazakii. Reported mortality rates among newborns infected with this bacterium fall between 40% and 80%. Experimental studies show that when hot water is first added to the bottle and the temperature is allowed to drop to roughly 73.8 °C prior to adding formula, the milk temperature stays above 70 °C in most cases. This process reduces the concentration of Cronobacter sakazakii by more than 5 logarithmic units, effectively bringing it down to under one ten-thousandth of its original amount. - Evidence grade: A - Sources:Beary MA, Daly SE, Baker J, Snyder AB (2025). Assessing Hot Water Reconstitution Instructions and Labeling of Powdered Infant Formula to Ensure Cronobacter spp. Reduction. Journal of Food Protection, 88(9), 100571. ；Sima WG, Legesse T, Girma S, et al. (2025). Emerging microbial risks: Cronobacter sakazakii in powdered infant formula for infants under six months of age in Ethiopia. BMC Microbiology, 26, 307. ；World Health Organization & FAO (2007). Safe preparation, storage and handling of powdered infant formula: guidelines. - Notes: The 70 °C threshold is specified in public health guidelines. Beary et al. explicitly state: “Public health guidelines for caregivers of high-risk infants recommend using water heated to at least 70 °C (158 °F) to prepare infant formula, in order to inactivate harmful microorganisms.” Premature infants, those with low birth weight, and babies under 2 months of age are at the highest risk of infection. Never use water that has been stored in a thermos for a full day to prepare formula, and do not leave prepared milk at room temperature for later use. ### 6. Do not feed honey to children under 1 year old - Cost: No cost involved - In plain terms: Never give honey to babies under 1 year of age. This includes honey water, honey mixed into baby food, and any baked goods containing honey. Honey can contain bacteria that cause botulism. An adult’s gut microbiome is able to keep these bacteria in check, but a baby’s cannot. The same rule applies to homemade pickled foods and fermented products. - Benefit: According to the Chinese CDC, “Do not feed honey to children under 1 year of age” because “honey may contain bacteria that cause botulism.” An adult’s gut microbiome can suppress these bacterial spores — the dormant form of the bacteria — while a baby’s cannot. - Evidence grade: A - Sources:US CDC. Preventing Botulism. - Notes: Foods and drinks to avoid include honey water, honey mixed into baby food, and any pastries containing honey. Likewise, homemade pickled foods and fermented products should not be given to infants. ### 7. Vitamin K injection at birth is essential - Cost: 0 to several dozen yuan. This cost is usually already included in the overall hospital delivery fee, so no extra payment is required. - In plain terms: Newborns naturally have very little vitamin K stored in their bodies. Without supplementation, it can lead to vitamin K deficiency bleeding; the delayed form often manifests as bleeding inside the brain. In regions where this injection isn’t routinely given, the incidence of such bleeding is about 478 cases per 100,000 newborns. Administering the injection is estimated to reduce this rate by over 78%. In China, all reputable hospitals routinely provide this injection during delivery. For home births or births at unregulated facilities, parents should proactively ask whether it was given. - Benefit: Newborns possess minimal vitamin K reserves. Failure to supplement may result in vitamin K deficiency bleeding, with the delayed type frequently presenting as intracranial hemorrhage. Belgian medical guidelines recommend a single intramuscular injection of 1–2 mg of vitamin K at birth. In areas lacking systematic prevention programs, the incidence of vitamin K deficiency bleeding is 478 cases per 100,000 newborns, based on data from 42,000 infants in Tashkent. The authors estimate that such preventive measures can lower the incidence by more than 78.5%. - Evidence grade: B - Sources:Fiesack S, Smits A, Rayyan M, et al. (2021). Nutrients, 13(11), 4109. ；Tursunov D, Yoshida Y, Yrysov K, et al. (2018). Nagoya Journal of Medical Science, 80(1), 11. - Notes: In reputable Chinese hospitals, this injection is administered routinely, so parents need not worry about it. However, for home births or births at unlicensed facilities, it’s crucial to confirm whether the injection was given. Oral administration is less effective than intramuscular injection. ### 8. Infants under 3 months with a body temperature of 38°C should be taken straight to the hospital — no home observation needed - Cost: Registration and tests cost several hundred yuan. - In plain terms: Infants under 3 months of age with a body temperature of 38°C must be taken to the hospital right away. Do not wait at home, and do not give them fever reducers first to see if symptoms improve. Even if an infant at this age has a serious bacterial infection, fever may be the only symptom they show. Therefore, the fact that a baby seems alert and in good spirits is not a valid reason to keep them at home. For infants under 8 days old, there are no relevant medical guidelines at all, so they must be seen by a doctor immediately. - Benefit: The American Academy of Pediatrics has issued specific guidelines for full-term infants aged 8 to 60 days who appear to be in decent health. These guidelines define fever as a body temperature of 38.0°C or higher. They further divide this age group into three subgroups — 8 to 21 days, 22 to 28 days, and 29 to 60 days — each with its own recommended course of action. Infants under 8 days old are not covered by these guidelines at all, which makes it even more imperative to seek medical care right away at this stage. - Evidence grade: A - Sources:Pantell RH, Roberts KB, Adams WG, et al. (2021). Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics, 148(2), e2021052228. - Notes: Infants at this age can have serious bacterial infections that only manifest as fever. So, the fact that a baby seems alert and in good spirits is not a valid reason to keep them at home. Do not give them fever reducers first and then wait to see if symptoms improve. ### 9. No matter how tired or angry you are, never shake a baby - Cost: There is no monetary cost. The real difficulty lies in resisting the urge to shake a baby when you’re exhausted or upset. - In plain terms: A baby’s head makes up a large proportion of their body size, yet their neck muscles are still very weak. Shaking them forcefully can cause bleeding inside the brain and eyes, potentially leading to death or lifelong disabilities. Gentle rocking while trying to soothe them is not dangerous; the real risk comes from uncontrolled, violent shaking. When you feel yourself losing control, place the baby back in their crib and step away for a few minutes. Letting them cry for a short while is far safer than holding them and shaking them. - Benefit: Because a baby’s head is proportionally large and their neck muscles are underdeveloped, violent shaking can result in intracranial and retinal hemorrhage — bleeding in both the brain and eyes. This can be fatal or leave lasting impairments. Such harm is distinct from any gentle rocking used to calm them. Medically, injuries caused by shaking or impact are termed “abusive head trauma.” This condition is the leading cause of death from head injuries among children under 2 years old. In the United States between 1999 and 2014, it accounted for nearly 2,250 deaths of children under 5. - Evidence grade: B - Sources:Spies EL, Klevens J (2016). Fatal Abusive Head Trauma Among Children Aged <5 Years — United States, 1999–2014. MMWR 65(20):505-509. ；Choudhary AK 等 (2018). Consensus statement on abusive head trauma in infants and young children. Pediatric Radiology 48(8):1048-1065. - Notes: When you truly feel you’re about to lose control, the safest action is to return the baby to their crib and leave the room for a few minutes. Allowing them to cry briefly is much safer than holding them and shaking them. This advice is especially vital for parents who care for their children alone and often suffer from sleep deprivation. For guidance on managing your own emotions, please refer to Section 3. ### 10. When choosing diapers, focus on three things: fit, how often you change them, and whether they’ve been flagged in any quality inspections - Cost: Prices range from a few hundred to over a thousand yuan per month, depending on the brand and quality level you choose. The absolute cost falls between 200 and 300 yuan per month. - In plain terms: No government agency has ever published an official ranking of “the best diaper brands.” The only information available comes from two sources: quality inspection reports issued by the State Administration for Market Regulation, and official investigations into specific incidents. A higher price tag does not guarantee safety, nor does being an imported product mean it meets safety standards. It’s wise to start by buying a small pack and using it for a week to check if your child develops rashes or skin irritation; only then should you consider buying in bulk. - Benefit: Since no official body has released any “best brand” list, this guide does not recommend any specific brands. The only verifiable data comes from two categories: first, inspection reports on product quality released by the State Administration for Market Regulation; second, official investigations into particular incidents. Following public concern in June 2026 over formaldehyde levels in infant diapers, the Administration formed a joint task force to conduct further checks. - Evidence grade: C - Sources:市场监管总局 (2026-06-22). 市场监管总局牵头成立联合调查组核查「婴幼儿纸尿裤甲酰胺问题」：「针对媒体反映的"婴幼儿纸尿裤甲酰胺问题"，市场监管总局、工业和信息化部、国家卫生健康委、国家疾控局高度重视，成立联合调查组，核查婴幼儿纸尿裤甲酰胺有关问题，并依法依规处理。有关情况将及时公布。」. ；中国政府网转载. - Notes: At the time of its formation, the task force stated only that “relevant findings would be released in due course.” As of September 30, 2026, neither the Administration’s official website nor recent national inspection reports contain any conclusions regarding infant diapers. In practice, higher cost does not equal greater safety, and imported products are not automatically compliant. Begin with a small trial pack to monitor for skin reactions; remember that rashes often stem from infrequent changes or poor breathability rather than brand choice. Instructions on how to access inspection reports are provided in Section 5. ### 11. Consider buying big-ticket items in the order “borrow, buy used, buy new” — don’t buy them all at once - Cost: No extra money is needed; the amount saved is usually in the thousands of yuan. The hard part is resisting the urge to buy everything at once. - In plain terms: Strollers, cribs, blankets, and toys are used for only a short time, and there’s plenty of them on the used market with few buyers. First, try to borrow them; if that’s not possible, buy used; only then should you consider buying new — this usually saves you thousands of yuan. However, it’s not advisable to buy used car seats or mattresses, since any structural damage from prior crashes isn’t visible to the naked eye. Things like postpartum care centers and early-education classes are optional big expenses; wait at least 24 hours before deciding. - Benefit: Strollers, cribs, blankets, and toys are all used for only a brief period, and the used market offers far more of them than there’s demand for. The only two items you really shouldn’t try to save money on — or buy used — are car seats and mattresses. Any structural damage to a car seat after a crash simply can’t be seen by looking at it. - Evidence grade: C - Sources:作者经验，无直接文献；安全座椅的证据见第 1 节，冲动消费见第 5 节 - Notes: This book neither recommends nor discourages postpartum care centers, early-education classes, or baby swimming classes. Still, they’re all optional big expenses, so the 24-hour cooling-off period described in Section 5 applies to them. ### 12. For children with severe eczema or egg allergy, don’t avoid peanuts — introduce them early under medical guidance, but never feed whole peanuts - Cost: A jar of peanut butter costs just a few dozen yuan. Feeding it a few times a week is easy to fit into a routine. Before starting, though, a doctor’s evaluation is required. - In plain terms: In a randomized trial of 640 high‑risk infants, those who ate peanuts regularly from 4 to 11 months of age had a peanut allergy rate of only 1.9% by age 5, compared with 13.7% in the group that completely avoided peanuts. Among children already showing a weak positive skin test at enrollment, the rates were 10.6% versus 35.3%. Avoiding peanuts actually raises the risk of allergy. However, whole peanuts must never be given, as they can block the airway. A total of 530 infants had negative skin tests at entry, while 98 had weakly positive results. - Benefit: The LEAP trial involved 640 infants aged 4–11 months with severe eczema, egg allergy, or both. One group ate peanut products regularly while the other avoided them entirely; at 60 months, only 1.9% of the eaters had a peanut allergy versus 13.7% of avoiders (P<0.001). Among 98 children with a weak positive skin test at entry, 10.6% of eaters were allergic versus 35.3% of avoiders (P=0.004). No serious adverse events differed between groups. - Evidence grade: A - Sources:Du Toit G, Roberts G, Sayre PH, 等 (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine, 372(9), 803-813. ；国家卫生健康委办公厅 (2020). 婴幼儿喂养健康教育核心信息. ；Perkin MR 等 (2016). Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants. New England Journal of Medicine, 374(18), 1733-1743. （备注里那项一般婴儿试验 EAT） - Notes: Peanuts must be given only as thinned peanut butter or powdered form mixed into food — never as whole nuts. The Health Commission clearly states: “Whole peanuts, nuts, jelly, and similar foods can be inhaled into the airway and cause choking; infants should avoid them.” For choking first aid, see Section 13, Item 26. This guidance applies only to high‑risk children with severe eczema or egg allergy. A medical assessment is mandatory before introduction; in the LEAP trial, children with a skin‑test reaction greater than 4 mm were excluded. Another study of 1,162 breastfed infants found no significant difference in overall food allergy rates between early‑introduction and standard groups, though a subset showed a clear benefit: 5.6% versus 7.1% (P=0.32) and 2.4% versus 7.3% respectively. Evidence for typical infants is far weaker. Early introduction appears safe, but Chinese official guidelines currently give no recommendation on this point; therefore this advice follows international trial evidence. Keep in mind that LEAP started at 4 months while Chinese practice recommends waiting until 6 months for solids — consult a doctor on timing and method for high‑risk children. ### 13. Watch newborn jaundice for these signals: yellow within 24 hours of birth, getting yellower, hard to wake or refusing feeds, pale stools — go to hospital the same day - Cost: Registration plus bilirubin testing, within a few hundred yuan. Phototherapy if needed is usually about two days in hospital. The hard part is making the trip even when the baby still looks okay. - In plain terms: More than four in five newborns have some jaundice; most clear on their own. Yellow before 24 hours of age, or getting yellower, unusually sleepy and hard to rouse, refusing feeds, or floppy or stiff — go to hospital the same day. Pale or white stools may mean biliary atresia; get checked quickly. Very high bilirubin can injure the brain and cause lifelong disability. - Benefit: The American Academy of Pediatrics 2022 guideline states that “more than 80% of newborns will have some degree of jaundice.” High bilirubin can cause acute bilirubin encephalopathy and kernicterus. The guideline calls kernicterus “permanent crippling neurological disease,” with choreoathetoid cerebral palsy, upward gaze palsy, enamel dysplasia of primary teeth, and hearing loss. “Jaundice appearing within 24 hours after birth” is listed as a risk factor for severe hyperbilirubinemia. The UK NHS parent guidance has two tiers. Tier one: call emergency services or go to emergency — jaundice plus more sleepy than usual or hard to wake, not feeding, floppy or stiff, or seizures; jaundice before 24 hours of age also counts. Tier two: see a doctor urgently — after 24 hours, jaundice not improving or worsening, dark yellow or brown urine, or pale cream-colored stools. Globally, an estimated 480,000 newborns in 2010 had Rh hemolytic disease (ABO/Rh incompatibility) or extreme hyperbilirubinemia; 24% died and 13% developed kernicterus. Among survivors of kernicterus, more than 83% had one or more lasting impairments. Pale stools may indicate biliary atresia; Kasai procedure before 60 days of age greatly improves prognosis. Since 2004 Taiwan printed stool color cards in every newborn health handbook; surgery within 60 days rose from 60% in 2004 to 74.3% in 2005. After the cards, mortality in biliary atresia fell from 26.2% to 15.9% in a Taiwan population study — before-after, not a randomized trial. - Evidence grade: B - Sources:Kemper AR, Newman TB, Slaughter JL, et al. (2022). Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 150(3), e2022058859. ；NHS. Jaundice in babies（2026-03-24 审阅）. ；NICE (2010, 2023 修订). Jaundice in newborn babies under 28 days (CG98), 1.2.6、1.7.1. ；Bhutani VK, Zipursky A, Blencowe H, et al. (2013). Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatric Research, 74(Suppl 1), 86-100. ；Hsiao CH, Chang MH, Chen HL, et al. (2008). Universal screening for biliary atresia using an infant stool color card in Taiwan. Hepatology, 47(4), 1233-1240. ；Lee M, Chen SC, Yang HY, et al. (2016). Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan. Medicine, 95(12), e3166. ；国家卫生计生委 (2017). 国家基本公共卫生服务规范（第三版），0～6 岁儿童健康管理服务规范. - Notes: Phototherapy uses special light on the skin to change bilirubin into forms that are easier to excrete. Do not substitute sunbathing at home: the AAP says sun exposure is hard to make both safe and effective, so it is not recommended as treatment. Do not give water or glucose water to “flush” jaundice — the guideline also advises against that. Visual yellow depth does not reliably estimate bilirubin level. UK NICE says not to rely on eyes alone; if unsure, measure once. Babies born before 38 weeks, siblings who had phototherapy, or insufficient breastfeeding raise risk of severe jaundice. Follow-up per the national basic public health service norm: home visit within one week after discharge; community health center or township clinic at 28–30 days — both visits check jaundice. If discharge orders include bilirubin recheck, go on that schedule. Full-term jaundice beyond 14 days or preterm beyond 21 days: NICE requires conjugated bilirubin testing and checking stool color. Jaundice alone does not delay vaccines (this section item 3). Newborn screening: Section 27, item 13 (heel-prick screening).