Understanding Kernicterus, a form of Brain Damage that occurs in Newborns as a Result of Jaundice

Many babies are born with the yellow-tinted eyes and skin indicative of jaundice. Jaundice is caused by high levels of bilirubin, which is the yellow substance created as the body rids itself of old red blood cells.

The yellow tint of jaundice can be harder to see in babies with darker skin color. The best way to measure bilirubin is to take a small blood sample from a baby’s heel. If the bilirubin level is high (hyperbilirubinemia), treatment will begin and repeat blood samples will usually be taken to confirm the bilirubin level is dropping with treatment.

The majority of infants with jaundice are treated quickly and easily, and the condition often resolves on its own. When left untreated, however, severe jaundice can lead to permanent neurological damage.

Kernicterus, a form of brain damage, occurs in some newborns as a result of severe jaundice. If levels of bilirubin are extremely high, the bilirubin begins to collect in a baby’s brain tissue, causing extensive and permanent brain injury.

Babies with kernicterus exhibit particular symptoms. They may alternately seem “floppy” or without muscle tone and then arch their backs or exhibit extreme muscle tone. They are excessively sleepy or lethargic, feed poorly or not at all, and may have a high pitched cry.

At the earliest stages, much of the damage caused by jaundice is reversible. As the condition progresses to include the above-mentioned symptoms, however, it can result in permanent hearing loss, athetoid cerebral palsy, severe brain damage and even death.

If your child is exhibiting any of these symptoms, you should treat the situation as a medical emergency and contact the appropriate medical professional.

Kernicterus is almost always preventable. Hospitals should have an established protocol for assessing newborns with jaundice and quickly providing the care they require. Treatment of infants with kernicterus includes phototherapy, feeding with formula, rehydrating with IV fluids and performing blood transfusions if necessary.

Phototherapy lights should be placed as close to the baby as possible with as much of the baby’s body as possible exposed to the light (with eyes covered), because blue spectrum light causes bilirubin to breakdown into a non-toxic form that dissolves into water which can be eliminated from the baby’s body.

Feeding babies, whether by mouth or using a feeding tube, is also extremely important in reducing bilirubin levels in infants. Bilirubin is eliminated from the body via stool and feeding infants formula, such as Nutramigen, gives their bodies a way to eliminate the bilirubin and prevent bilirubin levels from continuing to rise. Blood transfusions may be required to lower very high bilirubin levels in the most severe cases.

If bilirubin treatment protocols are not followed, or if there is a delay or interruption in treatment, a child’s life is endangered and permanent brain injury occurs.

Unfortunately, medical mistakes contribute to the incidence of kernicterus in newborn babies. Some of these preventable mistakes include:

• Doubting the extremely high bilirubin level reported form the lab, and waiting to start phototherapy and other treatment until a second lab result either confirms or corrects the abnormally high bilirubin level first reported;
• Removing the infant from the phototherapy lights and stopping phototherapy in order to transport the infant for testing; and,
• Measuring the bilirubin level but not comparing to the correct normal values (for example, a 24 hour old infant with a bilirubin level of 8.5 would be in the high risk category, but a 47 hour old infant with the same, 8.5, bilirubin level would be in the low risk category).

Because kernicterus is preventable with early detection, the fact that cases continue to surface is particularly deplorable.

No baby should suffer brain damage from untreated jaundice. One of the only options for a grieving family seeking justice is to begin a medical malpractice case.

If you would like to discuss your child’s potential claim arising from kernicterus, the attorneys at Yost Legal Group are experienced professionals ready to investigate your claim with compassion and determination. For a free consultation, please call us at 1-800-YOST-LAW (1-800-967-8529).