A flood of joy and exhaustion washes over you as you hold your newborn in your arms. Your baby is born healthy, and you marvel at their 10 fingers and 10 toes. Then something changes when you take your baby home.
Within a few days of birth, severe jaundice develops and, if not treated properly, can lead to kernicterus, a rare condition that can cause spinal cord and brain damage, even death.
What Is Kernicterus?
This serious medical condition can result from improperly or untreated jaundice in newborns. Jaundice results from elevated bilirubin in the blood. Bilirubin is a byproduct of the breakdown of red blood cells, a natural occurrence in the body. A baby is particularly susceptible to jaundice because their liver is not fully developed at birth, leaving the liver unable to process excessive levels of bilirubin in the blood.
When high levels of bilirubin are allowed to remain in the baby’s blood unchecked, jaundice becomes kernicterus and can damage the brain and nervous system. Kernicterus can develop as quickly as two to five days after birth.
While kernicterus is rare, jaundice is not. About 60 percent of full-term and 80 percent of premature babies develop the tell-tale signs of yellow skin and eyes. The lesser condition of jaundice is usually short-lived with no long-term effects. As the baby’s liver quickly develops, they are better able to handle the backlog of bilirubin. Also feeding your baby every two to three hours and exposing them to natural sunlight is often enough to resolve mild jaundice.
It is imperative that your medical team treats your baby for jaundice in its early stages.
Risk Factors of Kernicterus
Kernicterus is preventable but requires quick and appropriate action by the doctor.
There are certain factors that increase the chances of a baby developing kernicterus.
- Premature Birth. Babies born before week 37 are more vulnerable because the liver is one of the last organs to develop during gestation. A premature baby’s liver will be less efficient processing bilirubin than a full-term baby.
- Poor Feeding: When the liver processes bilirubin, the substance is excreted out of the body. Feeding problems can lead to less frequent stools and urination, keeping more bilirubin in the body.
- Genetic Predisposition: Babies with a family history of severe infant jaundice are at increased risk.
- Maternal Blood Type: Mothers with Rh-negative blood types or type O blood have shown to be more prone to delivering babies with high bilirubin levels.
The more time passes with unaddressed excessive bilirubin, the baby will develop worsening levels of permanent brain damage.
The specific symptoms of kernicterus manifest depending on the progression of the condition:
- Jaundice that does not resolve
- Difficulties with the baby breastfeeding or taking a bottle
- Lack of muscle tone, like a ragdoll when picked up
- Sudden, uncontrollable seizures
- High-frequency hearing loss
- Earlier lack of muscle tone changes to extreme stiffness
If you notice any of these symptoms, get emergency medical help.
The baby’s symptoms are an indicator of potential kernicterus. Your doctor can use a light meter to help determine the level of jaundice. A blood test can measure the levels of bilirubin in the baby’s blood.
Treatment Options for Kernicterus
Once kernicterus develops, there are no effective ways to reverse or repair the damage. The most effective treatment is prevention by adequately treating jaundice before it becomes severe.
If mild jaundice is elevated to moderate, other treatments can include:
- Phototherapy using an artificial light
- Blood exchange transfusions with some of the baby’s blood replaced by donor blood
Once moderate jaundice progresses to severe, there is no cure for kernicterus. If kernicterus is diagnosed in its early stages, it is possible to limit further damage to the brain and spinal cord.
Kernicterus Spectrum Disorder
Kernicterus Spectrum Disorder (KSD) describes the long-term effects of brain damage caused by bilirubin toxicity. The severity of symptoms usually depends on when any mitigating treatments were attempted. Symptoms are often similar to cerebral palsy.
The permanent effects of kernicterus can include:
- Developmental disabilities
- Movement problems
- Hearing loss or deafness
- Motor impairments
- Abnormal development of tooth enamel
Holding Medical Staff Accountable
Early diagnosis and treatment is critical to prevent mild jaundice from potentially becoming a permanently debilitating condition. Standard practice calls for checking for jaundice during the first 48 hours of the baby’s life and at the Day 5 wellness check. If kernicterus develops, it usually indicates medical malpractice. Failing to treat jaundice puts your baby unacceptably at risk. Kernicterus is life-altering for both the child and parents. Ongoing care will be costly.
Our skilled and compassionate lawyer at the Law Office of David A. Kates will fight for your family and to hold those charged with your baby’s care responsible. We are here to listen to your situation and discuss potential next steps, such as a birth injury lawsuit.
Contact us online or call (718) 866-3664 to see how we can help your family.