A Nationwide Birth Injury Resource

Jaundice, Bilirubin Encephalopathy and Kernicterus

Many newborns develop jaundice, which is a yellowing of the skin or whites of the eyes, in the first 48 hours after birth. This is a visible sign of hyperbilirubinemia, or too much bilirubin in the blood. According to a report from the Centers for Disease Control and Prevention, high levels of bilirubin are toxic to the developing newborn.

When properly treated, jaundice almost always goes away with no long-term complications for the baby. If it isn't treated, the elevated bilirubin levels can cause kernicterus - a serious brain injury with severe long-term consequences for the child's life.

Understanding the causes of jaundice and kernicterus

Bilirubin is a chemical that the body produces naturally as it breaks down waste. During pregnancy, the mother's liver removes bilirubin from the baby's body. After birth, if the baby's liver is not developed enough to remove bilirubin on its own, it can build up in the bloodstream, causing jaundice.

Jaundice usually begins in the face and then moves to the chest, belly, arms, legs and whites of the eyes. It is generally easier to observe in babies who have lighter skin and can be harder to see in babies with darker skin, but doctors and nurses can always check bilirubin levels with a blood test.

When caught early enough, jaundice is easily treated by putting the baby under a special light that helps to break down the bilirubin. Milk intake may also have to be increased to help the baby's liver and kidneys function. In severe cases, a blood transfusion may be needed.

Again, jaundice is a common and treatable medical condition. When it goes untreated and bilirubin levels continue to rise, the bilirubin can move from the bloodstream into the brain. At that point, it causes kernicterus, a severe birth injury.

Potential complications from brain damage caused by kernicterus include:

  • Dystonic or atheoid cerebral palsy
  • Hearing loss or deafness
  • Impaired eye movements
  • Auditory processing problems

Understanding your child's rights

Kernicterus is fortunately quite rare, but when it does occur, it's almost always for preventable reasons. Jaundice is incredibly common after birth - between 60-80 percent of newborns have it to some degree - and doctors and nurses have easily accessible tests that they can use to monitor for dangerous levels of bilirubin in the bloodstream. That means when kernicterus occurs, medical malpractice is usually to blame.

The long-term cost of brain damage is quite substantial, both emotionally, physically and financially. Families of children who develop kernicterus for preventable reasons have legal rights and options. The best course of action is to meet with an attorney licensed in your jurisdiction for a free consultation.