What is Kernicterus?

Does your newborn's skin look yellow? Does the white in your baby's eyes have a yellowish coloring? If so, your baby probably has a case of jaundice. Jaundice is more common than you might think; close to 60% of babies born in the U.S. have jaundice for a brief period of time. Most of the time, jaundice is harmless, but if your baby has a severe case, he or she could suffer from a form of brain damage known as kernicterus.

Jaundice vs. Kernicterus

Jaundice occurs often when a child is only a few days old. The baby's skin slowly starts to have a yellowish tinge to it which may darken over time. The yellow comes from a substance known as bilirubin. Bilirubin is the substance left over when red blood cells die. In most humans, the liver filters out the bilirubin and it causes no harm. For newborns, the liver often isn't strong enough to get rid of all the bilirubin. If there is build up of bilirubin in the blood, then the baby will look yellow. Usually, over a short period of time, the liver gets stronger and the bilirubin is removed from the blood. At that point, the jaundice goes away.

If a large number of red blood cells die, there could be a dangerous amount of bilirubin left in the blood. The skin of the baby could turn a darker shade of yellow or even orange. If this occurs, then the jaundice could be turning into kernicterus. Kernicterus is a form of brain damage caused by bilirubin. The bilirubin amount is so high in the blood that some of the bilirubin moves into the brain, causing brain damage.

Signs of Kernicterus

If a baby has kernicterus, it usually shows these signs:

• The skin is dark yellow or even orange.
• The baby is lethargic and has a hard time waking up or even staying awake.
• The cry of the child is high pitched.
• The newborn appears floppy due to decreased muscle tone.
• The baby arches its head and back into a contorted position.

If you suspect your newborn has any of these signs, you should take your baby to a doctor immediately.

Kernicterus Treatment

While it does cause brain damage, Kernicterus is treatable. Sometimes doctors commit a medical error and assume that since a child has kernicterus, it is too late to treat it. In fact, the sooner the bilirubin is reduced in the blood, the more likely the brain damage will be reduced and less of it will be permanent.

Treatment for kernicterus often includes:

• Phototherapy - The doctor treats the newborn by exposing it to ultraviolet light.
• Medications - Some medications can be given to babies to break down the bilirubin and remove it from the bloodstream.
• Blood exchange - This would be used only in severe cases.  The newborn's blood is removed and replaced with donor's blood that is free of bilirubin.