If jaundice in a baby goes unmonitored and untreated, it can develop into a potentially devastating condition known as kernicterus. Both jaundice and kernicterus involve excessive amounts of bilirubin, which is a pigment formed in the liver when red blood cells break down. An infant may be more likely to develop this problem because their liver cannot work fast enough to keep up with the rate at which their red blood cells break down.
By itself, jaundice usually does not cause serious concerns, and it does not require treatment in most children. A small percentage of children, though, may need to undergo treatment to lower their bilirubin levels. If a doctor does not monitor the progress of jaundice, or does not provide appropriate treatment when needed, excess bilirubin may reach brain tissue. This is when kernicterus arises. Toxic levels of bilirubin in the brain can cause permanent disabilities, such as cerebral palsy and hearing loss.
Symptoms and Diagnosis of Kernicterus
Symptoms of jaundice that may indicate a risk of kernicterus include yellowed skin or eyes, lethargy, poor appetite, and problems with reflexes. Symptoms that may signal the onset of kernicterus include problems with feeding or waking, irregular eye movements, and unusual stretching motions in the neck or heels. If the condition progresses, children may suffer from seizures, excessive stiffness or limpness, muscle spasms, and disruptions to their breathing.
A family history of elevated bilirubin levels, usually caused by conditions that accelerate the breakdown of red blood cells
Bruising caused by birth trauma, which can cause red blood cells to break down
Hemolytic disease, which arises when the mother and the baby have different blood types, causing a conflict between red blood cells and the antibodies inherited from the mother
In general, a doctor should check an infant for jaundice two or three times a day until they leave the hospital, and again a few days later. They can use a light meter to check for the presence of excess bilirubin. If this test shows a high level of bilirubin, blood tests can confirm the exact level of bilirubin in the infant. This will help a doctor decide whether a child should be hospitalized on this basis.
Treatment for Kernicterus
The prognosis for kernicterus depends on how promptly a physician responds to this emergency. Since it results from excessive bilirubin levels, a doctor will try to reduce the amount of bilirubin in the child through techniques such as light therapy. This involves placing lights above the baby to change the shape of the bilirubin and facilitate the process of excreting it. A doctor will regularly monitor bilirubin levels throughout this process, ensuring that the treatment is working. Bilirubin levels should fall into a safe range within about two days.
In especially serious cases, or situations in which light therapy does not resolve the problem, a baby may need a plasma transfusion. During this process, the baby receives blood without bilirubin to replace their blood. Sometimes a child needs multiple transfusions.
Compensation for Costs Arising From Kernicterus
If a doctor promptly and properly addresses kernicterus, a child may emerge with minimal problems. However, failing to diagnose and treat this condition very soon after it arises may cause serious or fatal consequences. If a doctor did not respond to kernicterus as quickly as they should have, the parents of a child who develops permanent disabilities can sue for compensation. Treatment for cerebral palsy and other lifelong conditions is expensive, and a child may never lead a normal life. Damages for medical malpractice can cover the economic costs of kernicterus complications, as well as the non-economic harm that a child suffered.
Parents generally should hire a birth injury attorney to pursue a claim on their behalf. These cases are more complex than ordinary personal injury lawsuits. Birth injury cases may involve technical procedural rules and typically rely on expert testimony. Medical experts will need to explain the professional standard of care that applied to the situation and how the defendant deviated from it. Experts also can describe the impact of permanent disabilities on a child.