Jaundice and Kernicterus

• Birth Injury
• Jaundice & Kernicterus

Newborn Jaundice and Kernicterus

A Common Condition that Can Lead to Infant Brain Damage

What are Jaundice and Kernicterus?

Newborn babies may develop a yellowish color in their skin and eyes in their first days and weeks of life. This condition is called jaundice. The substance causing the yellow discoloration is bilirubin.

When red blood cells break down, they produce bilirubin. Normally, the bilirubin travels to the liver, where it is broken down. It then is excreted from the body.

Newborn babies may have trouble getting rid of bilirubin through this process. They may develop “hyperbilirubinemia,” which means the baby’s blood has a high level of bilirubin. Hyperbilirubinemia can be dangerous when it is not treated.

Kernicterus occurs when prolonged high bilirubin levels allow bilirubin to cross the blood-brain barrier. Bilirubin is then deposited into the brain, causing severe brain damage and cerebral palsy.

How is unconjugated bilirubin different from conjugated bilirubin?

While discussing a baby’s jaundice, doctors may refer to “unconjugated bilirubin” and “conjugated bilirubin.” The levels of each type of bilirubin in the baby’s blood can indicate the extent of their jaundice.

“Unconjugated” means the liver has not processed the bilirubin into conjugated bilirubin.

“Conjugated” means the liver has turned bilirubin into a water-soluble substance that is ready to be cleared from the body.

Elevated bilirubin levels should concern any medical professional, particularly when caring for a newborn.

What Are Some Risk Factors For Jaundice & Kernicterus?

The medical professionals caring for a newborn should know if the baby is at risk for hyperbilirubinemia, severe jaundice, and kernicterus. Awareness of certain risk factors could cause closer scrutiny, increased testing, and earlier treatment.

For example, the babies of diabetic mothers are more likely to have jaundice. Also, it is more likely when Rh or ABO incompatibility exists between the mother and infant. Other risk factors include:

• Premature birth: Babies born before 38 weeks of gestation may have more trouble processing and passing bilirubin
• Race: Some studies indicate that infants of East Asian or Mediterranean descent are more likely to become jaundiced
• Breastfeeding: Babies that are breastfed may have trouble nursing or getting enough nutrition. This can lead to dehydration and jaundice
• Family history: A baby whose siblings or other relatives have had jaundice is more likely to develop it
• Birth trauma: This includes bruising, cephalohematoma, and misuse of instruments like forceps and vacuum extraction
• Genetic conditions: Some affect how blood cells are broken down or make it more difficult for bilirubin to clear from the baby’s body
• Baby’s Medical Condition: An unusually large baby (macrosomia) may be more at risk. Also, hypoxia (oxygen deprivation), including hypoxic-ischemic encephalopathy and acidosis (too much acid in the baby’s body), can increase the chance of developing hyperbilirubinemia
• Mother’s Medical Condition: Infections like sepsis, rubella, and syphilis can lead to hyperbilirubinemia
• Medications: Certain medications given to the mother during pregnancy and labor or to the baby post-birth can affect the baby’s ability to process bilirubin

Physicians and other healthcare professionals have a duty of care to their patients. In the case of a mother and newborn baby, they must watch for symptoms of jaundice. This is particularly true when the risk factors mentioned above are present.

Are There Common Symptoms For Hyperbilirubinemia (Jaundice)?

Doctors perform routine physical examinations of newborns and should notice the yellow discoloration that signals jaundice. It’s crucial to watch for jaundice in order to prevent the development of kernicterus, a more serious condition that causes brain damage. Medical staff should be alert for signs and symptoms of jaundice, especially in the baby’s first 24 hours.

• A skin test using a transcutaneous bilirubinometer
• Blood tests to check red blood cell counts, bilirubin levels, liver function, and Rh and ABO incompatibility

Failing to diagnose and treat infants with jaundice can permanently injure the child. It’s also can be medical negligence and medical malpractice.

Treatments For Newborn Jaundice

A baby’s medical team considers several factors when developing a treatment plan, including the baby’s:

• Age
• Gestational age (how long the baby grew in its mother’s uterus)
• General health
• Symptoms
• Type and severity of the baby’s jaundice

After medical professionals carefully assess the baby first, they might begin one of the following treatments:

• Phototherapy: Because bilirubin absorbs light, placing the baby under special lights for a time can decrease high bilirubin. The baby’s eyes should be covered to protect them from the lights. Also, staff members should check the baby’s temperature and bilirubin levels to see if the phototherapy is working as expected


• Fiber optic blankets: Like phototherapy, the baby is exposed to special lighting designed to decrease bilirubin levels. Blankets containing fiber optic lights are placed under the baby. Sometimes fiber-optic blankets are used along with phototherapy


• Exchange transfusion: This treatment may be used when the baby’s bilirubin levels are dangerously high. Doctors remove small amounts of blood, replacing it with blood that contains less bilirubin


• Supplemental feedings: Sometimes breastfed babies develop jaundice because they are not getting enough milk. Mothers should supplement feedings with pumped breast milk or formula to prevent or reduce jaundice

Doctors and other medical professionals must recognize the signs of jaundice and begin treatment immediately. When they fail to do so, babies could suffer life-altering brain damage.

What Are The Long-Term Effects of Jaundice?

Jaundice is highly treatable. Most babies with jaundice return to normal blood bilirubin levels within a few weeks.

But uncontrolled hyperbilirubinemia can cause bilirubin to cross the blood-brain barrier. When bilirubin is deposited into the brain, severe, irreversible brain damage can occur. This is called kernicterus.

Children with kernicterus (jaundice-related brain injury) may face:

• Hearing loss
• Movement disorders
• Auditory dysfunction
• Cerebral palsy

Once the damage is done, the lives of children and their parents are altered. The child might need medication, therapy, surgery, caregivers, and assistive technology. Medical negligence and malpractice are sometimes the root causes of birth injuries like kernicterus. If you feel your child might be the victim of kernicterus malpractice, please contact our Jaundice Lawyers as soon as possible. We can discuss pursuing compensation that can help pay for your child’s future medical needs.

Is Your Child’s Brain Injury the Result of Medical Malpractice?

The parents of children who suffered brain injuries often want answers. They want to know what happened to harm their child’s brain. Was it preventable?

Our dedicated birth injury lawyers want to help you find those answers. We will evaluate all records during the delivery and neonatal care of your child to determine if their jaundice was properly diagnosed and treated.

We diligently investigate the facts and hold responsible parties in a kernicterus lawsuit case by pursuing medical malpractice claims against them. The compensation our clients receive helps them pay for their child’s current and future medical treatment, assistive technology and equipment, and the other expenses associated with caring for a child with brain injuries caused by elevated bilirubin, untreated jaundice, and resulting kernicterus.

Sometimes families are afraid to talk to lawyers about their child’s case. Others may simply feel overwhelmed by their circumstances and unable to participate in a lawsuit involving their child’s birth injury.

Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injury.

At Miller Weisbrod Olesky, a team of committed professionals uses our detailed case review process to assess your potential claim. They start by learning more about you and your child. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.

If we feel medical malpractice was present, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.