Infant Jaundice, Kernicterus and Birth Injuries

When to consult with a birth injury attorney about your baby’s jaundice

Parents of newborns often feel a mix of anxiety, worry, excitement, and joy when welcoming a baby into their families. From minor concerns, such as whether they have enough diapers, blankets, and other supplies, to questioning their own capabilities to be good parents, it’s not uncommon for mothers and fathers of infants to experience stress. This is normal.

But if a severe injury or serious problem occurs during childbirth, it often causes stress levels to rise even further, especially if a parent doesn’t know where to seek support.

Unless a parent has a medical background that includes a formal study of obstetrics or newborn child development, they likely aren’t able to fully understand everything a medical team is doing or saying when it comes to monitoring a newborn’s health condition.

What is newborn jaundice?

To better understand potentially dangerous birth injuries such as neonatal jaundice, it’s helpful for parents of newborns to learn about bilirubin.

Jaundice is an excess of bilirubin in an infant’s bloodstream. A properly trained medical team should know what to do to treat a baby for jaundice and should instruct parents accordingly. In a postpartum care unit, an infant should be checked for signs of jaundice approximately every 8 to 12 hours.

Parents should continue to monitor their baby’s condition upon returning home because jaundice can occur days later.

What causes newborn jaundice levels to be unhealthy?

There are several known causes and risk factors for an excess buildup of bilirubin in an infant’s bloodstream, including:

• Birth before 38 weeks gestation
• Sepsis (infection in the blood)
• Enzyme deficiency
• Liver malfunction
• Incompatibility between a mother’s blood and her baby’s blood

These factors can all contribute to elevated bilirubin levels, necessitating careful monitoring and, in some cases, medical intervention to prevent complications such as kernicterus, a rare but serious neurological condition that can occur in newborns with severe jaundice.

What are the signs of jaundice in babies?

Infant delivery teams should be specially trained to closely monitor the condition of a newborn infant and mother. A low APGAR score can alert nurses or doctors to potential problems. The “A” in APGAR refers to an infant’s appearance.

The most common symptom of jaundice in an infant is a yellowish skin tone. This symptom may also appear in the whites of an infant’s eyes. To check for discoloration, a parent or medical team member can gently press on a baby’s forehead or nose.

In addition to a yellowish skin tone, other symptoms of infant jaundice include:

• Discoloration of the abdomen
• Difficulty rousing an infant from sleep
• Failure to thrive regarding feeding and gaining weight
• High-pitched crying

If you notice any of these signs in your newborn, it’s important to contact your pediatrician right away.

How doctors diagnose and treat infant jaundice

A postpartum care doctor should know how to physically examine an infant, as well as what tests to run—including lab tests or a skin test using a transcutaneous bilirubinometer—to measure an infant’s bilirubin level.

Mild cases of jaundice often resolve on their own within a few weeks, but common treatment for more serious cases can include:

• Enhanced nutrition
• Light therapy (using a special lamp that changes the molecular structure of bilirubin to help excrete it from the body)
• Intravenous immunoglobulin transfusion or blood transfusion

While most cases of newborn jaundice resolve without the need for such treatments, moderate-to-severe jaundice requires prompt medical attention to prevent complications like kernicterus.

Lack of treatment or failed response to treatment may result in kernicterus

Bilirubin has a specific function in the liver. However, it’s toxic to the brain. If a baby has jaundice, excess levels of bilirubin may pass to the brain, which can cause “kernicterus”—a term that refers to a spectrum of conditions associated with brain damage.

What are the signs of kernicterus?

Symptoms of kernicterus can include:

• Inconsolable, high-pitched crying
• Bulging of a baby’s fontanelle (soft spot on top of the head)
• Erratic eye movements
• Seizures

These and other symptoms would alert a postpartum medical team to possible kernicterus, resulting from untreated jaundice.

FAQs

What bilirubin level is kernicterus?

Kernicterus typically occurs when bilirubin levels exceed 25 mg/dL (milligrams per deciliter) in a newborn’s blood. However, the exact level at which kernicterus develops can vary depending on the individual baby’s health, maturity, and the presence of other risk factors.

Can a baby recover from kernicterus?

A baby can recover from kernicterus, but the extent of recovery depends on the severity and duration of the high bilirubin levels before treatment.

Early intervention and treatment can prevent or minimize brain damage, but severe cases can result in long-term neurological issues such as cerebral palsy, hearing loss, vision problems, and intellectual disabilities.

The key to improving outcomes is prompt and effective treatment to lower bilirubin levels and prevent further damage.

Is kernicterus curable in adults?

Kernicterus in adults resulting from jaundice-related brain damage during infancy is not curable. Once the damage is done, it cannot be reversed.

In such cases, treatment generally focuses on managing the symptoms and complications that arise from the condition, such as movement disorders, hearing loss, and other neurological impairments.

However, while quite rare, some adults with certain underlying genetic conditions can develop kernicterus later in life.

In one study published in the National Library of Medicine, patients with these genetic defects benefited from phenobarbital treatment, which was shown to help maintain bilirubin levels and prevent the onset of kernicterus.

Is kernicterus considered medical negligence?

Yes, medical negligence is often a direct cause of kernicterus.

If a licensed medical team fails to take appropriate action to monitor an infant’s health or to perform proper examinations, tests and treatment if a child exhibits symptoms of jaundice, it places the child at risk for severe brain injury.

If left untreated, kernicterus may lead to coma or infant fatality. Babies who survive kernicterus often require specialized care, such as cochlear implants for hearing loss, speech therapy, orthopedic devices and daily life function support.

Get help from a birth injury attorney with experience in kernicterus cases

When an infant suffers a birth injury due to medical negligence, parents may encounter severe financial obstacles like high medical bills, lost wages from time off work to care for their child, or any number of other issues.

In such cases, parents may decide to act on their child’s behalf to seek restitution against those who are responsible for damages. The first step to take in seeking financial compensation from a negligent doctor or medical team is to discuss your case with a qualified legal professional.

At Brown Trial Firm, experienced birth injury attorney Laura Brown is well-versed in all aspects of medical negligence law and can provide the specialized knowledge and support you need throughout your case to get your family the compensation you need to help your child thrive.

Get started today by scheduling your free consultation with Brown Trial Firm.

References

Bai, J., Li, L., Liu, H., Liu, S., Bai, L., Song, W., Chen, Y., Zheng, S., & Duan, Z. (2021). UGT1A1-related Bilirubin Encephalopathy/Kernicterus in Adults. Journal of Clinical and Translational Hepatology, 000(000). https://doi.org/10.14218/jcth.2020.00108