Frequently asked questions

Neonatal jaundice, or hyperbilirubinemia, occurs when a newborn’s blood contains high levels of bilirubin, a yellow substance produced from the breakdown of haemoglobin in red blood cells.

Adults generate about 2.4 million red blood cells every second, producing a substantial amount of bilirubin. The liver processes and removes this bilirubin from the body. In adults, some bilirubin in the blood is normal and not harmful due to lower levels and a fully developed blood-brain barrier preventing bilirubin from entering the brain.

In newborns, however, the situation is completely different. In the womb, fetuses use a special kind of haemoglobin (fetal haemoglobin) to extract oxygen from the mother’s blood efficiently. This fetal haemoglobin becomes unnecessary after birth when the baby starts breathing independently. Consequently, the baby’s body rapidly breaks down red blood cells to replace fetal haemoglobin with adult haemoglobin, increasing bilirubin production. However, since the liver is not fully developed in some newborns, their ability to process bilirubin is limited. The blood-brain barrier might also be underdeveloped, allowing bilirubin to enter the brain, which can be harmful.

While neonatal jaundice is a common and usually temporary condition in newborns, affecting 60 to 80% of them (84 to 112 million cases annually worldwide), it typically appears within 48 to 72 hours after birth and resolves within 3 to 7 days. However, about one in ten newborns affected by jaundice may develop significant jaundice, necessitating close monitoring and treatment. Failure to detect and manage high bilirubin levels can lead to brain damage or even death, as excessive bilirubin might cross the underdeveloped blood-brain barrier. 

Picterus® Jaundice Pro is a jaundice screening device approved for clinical use by healthcare professionals and caregivers of newborns (e.g. parents).

Picterus® Jaundice Pro can only be used on newborns who:

1. Are born with gestational age between 37-42 weeks.
2. Have a birth weight between 2500-4500 gr.
3. Are between 1-14 days old.
4. Have parents with skin colour, according to Fitzpatrick, scale 1 to 4 in Figure 1. The six Fitzpatrick skin types and associated hair and eye colour are classified from very light (1) to very dark skin (6), as shown below. The Picterus® Jaundice Pro app is only valid for skin types 1 to 4. 

Figure 1 Fitzpatrick skin type scale 

Picterus® Jaundice Pro app must not be used on newborns who:

1. Have pathological jaundice.
2. Are highly likely to develop pathological jaundice because of incompatible blood type or haemolytic jaundice.
3. Have other medical conditions that require medical treatment.
4. Have received phototherapy.
5. Have had the chest region exposed to sunlight over the last 24 hours. Sunlight changes the relationship between the amount of bilirubin in the blood and the skin and can thus make the measurements less accurate.

Yes, pictures must only be taken on the infant’s chest, as shown in the instructions for use. The skin must be clean, undamaged, and dry. The skin must not have been lubricated with moisturizing cream, oil, etc. The skin must not be affected by any skin condition or disease other than jaundice.

Download the Picterus® Jaundice Pro App from Google Play or App Store on your mobile phone. Follow the instructions as stated in Google Play and App Store.

Picterus® Jaundice Pro is compatible with all phones that have not previously reported any problems. If you attempt to use the app on a phone with known issues identified by Picterus AS, an error will be reported.

For an updated list of compatible devices and known issues, click here.

Yes, to use Picterus® Jaundice Pro, your mobile phone must be connected to the internet.

For the best results, please refer to section 4.2 in the instructions for use and consider the following practical tips:

• The measurements are easier to perform when the baby is calm, for example, by using the app after feeding.
• Babies often move with their arms. Ask someone to gently hold their hands.
• Take the photos in good light conditions and avoid shadows.
• Place the Picterus® Calibration Card on a flat part of the baby’s chest, avoiding shadows.

Failure messages are often shown due to the rejection of a measurement. This is a safety measure to avoid inaccurate measurements. Rejection of a measurement can happen due to low image quality, e.g., too little light. If you get a failure message, try again by turning on an extra light or measuring the newborn in a different place. Make sure your camera lense is clean. Moreover, shadows should be avoided when doing the measurement. You can also try some of the suggestions stated in question 8.

As stated in the instructions for use, the camera should be positioned to point towards the chest, ensuring that the flash is not directed at the newborn’s eyes. This approach has been shown to be safe. Additionally, no undesirable side effects have been reported in the relevant literature or found in the clinical studies of the Picterus® Jaundice Pro, which involves using a smartphone to capture images of the newborn’s skin.

Picterus AS does not collect or process personal or sensitive personal information other than your email adress witch is needed for loggin in. For further details, please read the Picterus AS privacy policy.

The image below is an example of what Picterus AS receives from measurements. The background of the image is blacked out, only the Picterus® Calibration Card and the imaging window are retained to make the measurement. As shown in the sample below, the app only processes anonymous calibration data for functionality. Personal photos are not retained. 



For further details, please read the Picterus AS privacy policy.

One Picterus® Calibration Card can be used for multiple screenings on a single newborn and needs to be disposed of after use.

The sticker on the back of the Picterus® Calibration Card is intended and approved for use on the skin. Please note that the sticker is only present on an old version of the card which is no longer in use. From the 12th of June 2024, Picterus ® Calibration Cards do not come with a sticker on the back anymore. 

To order Picterus® Calibration Cards, please click here and follow the instructions.

For general questions, please contact Picterus AS at contact@picterus.com

A successful screening with the Picterus® Jaundice Pro app means:

1. Six high-quality images are taken.
2. Keep your phone in position until the app confirms that all six images have been taken. This
   will be clearly indicated on the screen.
3. Wait for the result: The Picterus bilirubin value is calculated and displayed in the app within
   seconds. The result will be shown in mg/dL or μmol/L, depending on your app settings.
4. You only pay for a successful screening: If the app cannot provide a result (e.g., if the
   measurement fails), it is not considered a successful screening, and you will not be charged.

• Tap the menu in the top left corner to view your measurement history.
• All previous measurements are listed, sorted by date, with the most recent at the top.

You pay for each successful and completed screening. This means that six images (three with flash,
three without) have been taken, and the app has provided a result.