Kernicterus

Kernicterus is a rare type of brain damage that occurs in a newborn with severe jaundice (yellowing).  Bilirubin is a brownish-yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool.

When bilirubin levels are high, the skin and whites of the eyes may appear jaundiced (yellow). Too much bilirubin in a newborn baby can cause brain damage (kernicterus), hearing loss, physical abnormalities, and even death. Therefore, some babies who develop jaundice may be treated with special lights (phototherapy) or a blood transfusion to lower their bilirubin levels.

It is not uncommon to see elevated bilirubin levels in newborns, usually one to three days old. Within the first 24 hours of life, up to 50% of full-term newborns, and an even greater percentage of premature babies, may have elevated bilirubin levels. After birth, newborns begin breaking down the excess red blood cells they are born with. Since the newborn’s liver is not fully mature, it is unable to process the extra bilirubin, causing the infant’s bilirubin levels to rise in the blood and other body tissues. This usually resolves itself within a few days.

Elevated bilirubin damages developing brain cells in infants and may cause learning and developmental disabilities, hearing loss or eye movement problems. There is no need of any special treatment for a mild rise in bilirubin levels or mild hyperbilirubinemia in newborns. To treat moderate hyperbilirubinemia, newborns are required to be placed under bilirubin lights where only the eyes are shielded with a blindfold to avoid any kind of damage.

If elevated bilirubin goes untreated, it often contributes to kernicterus, a rare type of brain damage that will have life-long consequences to the baby and the family. Because kernicterus may be the result of medical malpractice, there should be an immediate investigation of the entire labor and delivery process to determine whether this injury could have been prevented.

A low-level buildup of bilirubin is normal. This is called mild jaundice, and it gives a newborn a slightly yellowish tint to the skin and sometimes the eyes.

After birth, it takes a few days for the newborn’s liver to effectively remove bilirubin from the blood. With feedings every two to three hours, mild jaundice will usually go away on its own after a few days. If a baby has any signs of jaundice at birth, he or she needs to be watched closely.

Kernicterus has likely already started if a baby has one or more of these symptoms: extreme sleepiness and lethargy; does not respond to touching or does not startle from sudden movements; an abnormal high-pitched cry; poor muscle tone, including unusual muscle flexing; seizures; and a fever.

Long-term damages from kernicterus include movement difficulties, hearing loss or deafness, learning problems, developmental disabilities, and problems moving eyes.

Your doctor diagnoses kernicterus through a physical exam and knowledge of a child’s history. Blood tests to measure bilirubin levels are also done. So, the question is, can kernicterus be prevented? Yes, with proper testing and treatment.

If a baby is still in the hospital and has signs of jaundice, the doctor will perform a blood test measuring the bilirubin level. High levels require treatment, either by phototherapy or blood transfusion. Also, babies should be fed at least every one to three hours during the first couple of weeks of their life as this helps keep bilirubin moving out of the body through urine and stool.

Quick treatment may help prevent further brain damage. Long-term treatment for brain damage depends on a child’s specific problems. Typical treatment includes physical therapy, speech therapy and special education.

Kernicterus can have life-long consequences to a baby and its family. This calls for an immediate and careful investigation of the entire labor and delivery process to determine whether this injury could have been prevented. Often, evidence in the medical records shows significant problems and gives clear proof that the unfortunate outcome could have been prevented with responsible medical care.

If your baby is suffering from kernicterus, it could be the result of a birth injury. Call Thering, PLLC at 866-996-7123 for a free consultation.

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