Kernicterus Birth Injuries: Severe Jaundice in Newborns

Some newborns with severe jaundice develop kernicterus, a medical emergency which can cause devastating injuries.  This condition is almost always preventable.


Jaundice is common (about 60%) in newborns and results in yellowed skin and eyes.  The condition is caused by too much bilirubin in the blood.  Bilirubin, made by the normal breakdown of red blood cells, is usually removed from the body by the liver.  Infants with jaundice have too much bilirubin (hyperbilirubinemia), and their livers cannot keep up with the excessive bilirubin.

Stages and Treatment of Kernicterus

Unlike jaundice, kernicterus is rare.  It is a medical emergency that usually develops between the first and third weeks of life.  The excessive bilirubin builds up and collects in the brain, which can cause permanent injuries and begins affecting the brain immediately.  Careful doctors and nurses must monitor the infant so that they can timely diagnose kernicterus injuries.  The symptoms include:

    • Early stage kernicterus:  extreme jaundice, no startle reflex, sleepiness, poor sucking reflex, fever
      • Mid-stage kernicterus:  high-pitched cry, bulge in the head’s soft spot (fontanel), seizures, arched back
        • Late-stage kernicterus:  hearing loss, movement disorders, seizures, muscle rigidity, mental retardation

        The American Academy of Pediatrics recommends that bilirubin levels be measured within 24 hours of the first symptoms of jaundice.  Furthermore, infants discharged from the hospital within 24 hours of birth should be evaluated by 72 hours—earlier if the baby has risk factors.  A simple blood test can diagnose kernicterus.  Some doctors make the mistake of delaying treatment while blood tests are repeated.  The infant should usually be placed on phototherapy (a process where special lights help the body to get rid of the excessive bilirubin) and given fluids.  In severe cases, the baby may require blood transfusions.

        Most cases of kernicterus are observable, and severe injury is almost always preventable.  Health care providers must pay attention to the warning signs, and act immediately when those warning signs occur.  In particular, blood transfusions may take some time to set up, so doctors and nurses must be proactive.

        Upon discharge, all parents should be warned of the signs and symptoms of jaundice and kernicterus.  If parents are not aware of these symptoms, the child may experience brain damage before treatment is possible.

        Injuries Caused By Kernicterus

          • Hearing loss

          Contact Us

          If your child developed jaundice, hyperbilirubinemia, or kernicterus shortly after birth, and now has severe injuries, he or she will likely require a lifetime of special medial and therapeutic care.  Contact our medical malpractice lawyers at (855) 712-7818 or online for a free consultation.

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