Kernicterus and Jaundice Can Lead to Cerebral Palsy

Background Information

Bilirubin is a yellow chemical produced in the blood from the normal breakdown of red blood cells (red corpuscles, erythrocytes). Bilirubin travels to the liver where a chemical reaction takes place to remove it from the blood. Sometimes however, the liver cannot remove enough bilirubin from the blood, and the amount of bilirubin in the blood increases. This extra bilirubin travels to all parts of the body in the bloodstream and causes the skin to turn yellow. The medical term for this yellow skin color is jaundice. The medical term for the extra bilirubin in the blood is hyperbilirubinemia.

Besides causing the skin to turn yellow, the bilirubin can cause damage to a baby's brain. This happens when excessive bilirubin remains in the body for too long. The yellow color of the skin is the clue that there is a problem and that treatment is required, so that Kernicterus can be avoided.

What is Kernicterus?

Kernicterus is the name given the disease where too much bilirubin in the blood causes brain damage. The name Kernicterus comes from two Greek words - kern which refers to a portion of the brain, and icterus, which means yellow.

The brain is the part of the body most severely damaged by prolonged exposure to extra bilirubin in the blood. Severe damage to the brain can result in the child's death. If the baby lives, they may experience deficits such as cerebral palsy, mental retardation, or problems with vision and hearing.

What are some warning signs of Kernicterus?

The most common sign that a baby is at risk for Kernicterus is yellowing of the skin, especially in the first 24 hours after birth. Sometime, the whites of the baby's eyes may turn yellow too. Other signs are a baby who is not alert or who is difficult to wake up. Babies with Kernicterus often have a shrill, high pitched cry and may appear weak or limp. Sometimes they lie unnaturally in bed with their bodies arched upward when lying on their backs.

Does jaundice always lead to Kernicterus?

No. Many babies have jaundice when they are a few days old, but with proper treatment it almost always goes away. Early diagnosis and treatment is the key to avoiding brain damage.

Are some newborn babies more likely to become jaundiced than others?

Yes. Newborn babies more likely than others to develop jaundice include those who suffered a bruise during childbirth, those born early (prematurely), those who are not nursing well, those who have a brother or sister that had jaundice, and those born to an African American, East Asian, or Mediterranean family in whom G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency is common.

Can jaundice be treated so that Kernicterus will not develop?

Absolutely. Many times, jaundice will go away without treatment. However, if treatment is required, the main treatment is a simple one. Babies are placed under special blue lights for a number of hours, or wrapped in a "bili-blanket". This is called phototherapy. It helps remove the bilirubin from the blood which can cause Kernicterus. The blue lights are warm and do not cause any harm to the baby.

If the baby gets very, very jaundiced, the doctor can do a blood transfusion to remove the extra bilirubin. This is called an "exchange transfusion."

No baby should develop brain damage from untreated jaundice.

What should I do if I think my baby has jaundice?

You should contact your baby's doctor and arrange for a visit.

If I have a child with Kernicterus, what can I do?

If your baby has Kernicterus, you may have a medical malpractice claim against healthcare providers who caused this injury. The malpractice claim is for the harm your child has suffered, and for the cost of care and treatment for your child.

Contact the Brain Injury Law Group: 1-800-992-9447

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