Jaundice, Kernicterus and Cerebral Palsy
Jaundice is a condition that an estimated 60% of all babies experience. While this condition is certainly common, especially among newborns, it’s important to know the signs and treat jaundice as soon as possible to prevent the development of kernicterus, which could lead to permanent conditions such as cerebral palsy. Learn about the symptoms of jaundice and how it’s diagnosed as well as the symptoms and risk factors of kernicterus in newborns.
What Is Jaundice?
Jaundice is a condition characterized by the yellowing of the skin. In newborns, this condition is a result of a buildup of bilirubin—a product from the normal breakdown of red blood cells—in the baby’s blood and body. Jaundice is typically harmless when treated quickly and appropriately. Newborns are susceptible to elevated bilirubin levels for a number of reasons:
- Premature infant jaundice. Premature birth results in babies’ livers being less developed and therefore less able to cycle out bilirubin from their bodies.
- Suboptimal intake jaundice. Inadequate caloric intake as a result of less than ideal breastfeeding circumstances can lead to elevated bilirubin levels but can often be addressed by adequate medical intervention and breastfeeding support.
- Breast milk jaundice. Often in the second or even later weeks of life, breast milk jaundice happens when breast milk causes the baby’s bilirubin levels to rise, although the exact causes of this are not yet completely understood.
- Blood incompatibility jaundice. Jaundice can also be caused by blood type incompatibilities, such as a mother with O blood and a baby with A or B blood, or untreated Rh factor incompatibilities.
- Physiologic jaundice. Newborns produce more bilirubin because of their shorter red blood lifespan and high number of red blood cells. Combined with immature liver function and delayed passage of meconium—baby’s first waste—jaundice sometimes just happens in otherwise healthy newborns.
What Are Jaundice Symptoms?
Jaundice will typically appear shortly after birth and is often easy to detect due to the yellow tint it causes on the skin. This yellow tint may be seen on the face, stomach, legs, neck, head, toes, or arms.
Additional symptoms of jaundice include:
- Trouble falling asleep or waking up
- Unusual or excessive fussiness
- Not sucking from the bottle or breastfeeding
- Not enough dirty or wet diapers
More severe symptoms of jaundice include:
- Unusual eye movement
- Crying inconsolably or with a very high pitch
- An arched or very stiff body
- Muscles that are too relaxed or loose
If your baby is experiencing any of these symptoms, seek treatment with your pediatrician immediately. For more severe jaundice symptoms, get emergency help as soon as possible.
What Are Kernicterus Signs and Symptoms?
If jaundice is left untreated or is very severe, babies may develop a condition called kernicterus. This will only happen if extremely high levels of bilirubin build up in the baby’s body and enter the brain, causing damage to the central nervous system. Kernicterus has three stages, and each stage has specific symptoms:
- Evident jaundice
- Hypotonia, or muscle weakness and decreased muscle tone
- Trouble with feeding or not wanting to feed enough
- Hypertonia, or extreme stiffness of the body
- Very loud and high-pitched crying
- Trouble with movement
- Hearing loss
- Speech issues
- Extremely rigid muscles
- Intellectual and/or mental problems
In severe cases, kernicterus can result in death. If kernicterus is not treated quickly enough, the excess bilirubin in the brain can permanently damage the brain’s gray matter and affect the baby’s balance, eye movement, hearing, and coordination. Kernicterus can also cause two different types of cerebral palsy: dystonic cerebral palsy and athetoid cerebral palsy.
How Is Jaundice Diagnosis?
If your newborn is exhibiting signs of jaundice, your doctor will likely perform a jaundice bilirubin test to check the levels of bilirubin in the baby’s body. This can be done by using a light meter or by taking a small blood sample. The levels are evaluated based on the infant’s age in hours and their risk factors. If your infant has jaundice, their bilirubin levels will be checked every eight to 12 hours for their first 48 hours of life and several more times before the baby is five days old.
What is the Treatment for Jaundice?
Babies being treated for jaundice will be placed under special lights (phototherapy) until the bilirubin levels decrease to a safe level. More severe cases of jaundice may require a blood exchange transfusion to remove the high bilirubin levels in the baby’s blood. The same measures will likely be taken if the baby is diagnosed with kernicterus in order to decrease the high amounts of bilirubin in the blood.
Research has shown that even without the development of kernicterus, high levels of bilirubin can cause severe motor symptoms and cerebral palsy. Treating jaundice early and appropriately is crucial, and doctors may even decide to assess for other risk factors in order to determine your baby’s best treatment options. If your child has been diagnosed with cerebral palsy as a result of kernicterus or other complications from elevated bilirubin that developed after not receiving adequate or prompt treatment for jaundice, you may have a case for medical malpractice and could be eligible for compensation.
The Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC have consulted with over 30,000 families nationwide. We call upon our legal and medical experience to uncover the truth and recover the compensation families deserve. If your child suffered from medical malpractice that led to cerebral palsy, contact us today for a free, no-obligation consultation.
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant
Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO