Q. What is kernicterus?
A. Kernicterus is a neurological condition caused by excessive bilirubin (hyperbilirubinemia) that moves from the bloodstream into the brain in the days after birth. It results in hearing problems, movement disorders, cerebral palsy and delayed development.
Q. What is bilirubin?
A. Bilirubin is the substance that every human produces when red blood cells break down normally. Newborns have more red blood cells than adults as well as immature livers, and the breakdown of red blood cells after birth can cause excessive levels of bilirubin. Neonatal jaundice, yellowing of the eyes and skin, is the result in at least 60 percent of newborns.
Q. Is jaundice dangerous?
A. Jaundice is easy to diagnose and very treatable in almost all cases. Jaundice is only dangerous at high levels in healthy newborns when left undiagnosed and untreated. It is much more dangerous in premature or sick newborns.
Q. Is kernicterus preventable?
A. It is almost entirely preventable by following accepted medical protocols regarding testing, diagnosis and treatment. When a baby shows signs of jaundice, or yellowing of the skin and eyes, he or she should undergo a simple blood test that measures the amount of bilirubin in the bloodstream. If the test indicates that the infant has excessive levels of this substance, the physician should prescribe treatment immediately to reduce the bilirubin levels and the possibility of kernicterus.
Q. What is treatment for jaundice?
A. Jaundice is usually treated by phototherapy, which involves placing the baby under blue light/white light florescent bulbs, using a bili-blanket or using high-intensity LED lights. When a baby has extremely high levels of bilirubin that do not respond to phototherapy, physicians may use exchange transfusion, which removes the infants blood and replaces it with new blood.
Q. What are the risk factors for jaundice?
A. Risk factors for jaundice and kernicterus include prematurity, feeding difficulties in the first days of life, a mother with RH-negative factor or O blood type, a mother with diabetes and siblings who were treated for jaundice at birth.
Q. What are the signs and symptoms of kernicterus?
A. Kernicterus is caused by very high levels of bilirubin (hyperbilirubinemia), which is a yellow pigment that is created in the body as part of the recycling of old blood cells. When the bilirubin levels become too high, the skin can look yellow, or jaundiced. Other symptoms of hyperbilirubinemia include lethargy, failure to show a startle reflex, high-pitched cry, arched back or neck, bulging soft spot and seizures.
Q. What is the treatment for kernicterus?
A. There is no treatment once permanent brain damage has occurred. If parents recognize the early symptoms of kernicterus, they should immediately take the baby to the emergency room to start intensive phototherapy to prevent further damage.
Q. Where can I obtain information about kernicterus?
A. Because kernicterus is a rare condition, information is not readily available. Finding doctors who understand this condition is not always easy. Our Resources page lists some Internet sites that are helpful, including the site operated by P.I.C.K., the website for Parents of Infants and Children with Kernicterus.
Q. What can I do once my child has been diagnosed with kernicterus?
A. In addition to finding the right doctor, parents should seek out a knowledgeable attorney. This condition lasts a lifetime; parents need to know about resources available to them as they develop plans for caring for their child. Our law firm, Todd & Weld LLP, has developed a nationwide kernicterus practice and our lawyers help families obtain the resources they need to move forward.
To learn how Todd & Weld LLP can advocate for you in a kernicterus case, contact our lead kernicterus practice area partner, attorney Jeffrey N. Catalano, at 617-391-0591.