It is a common misconception that jaundice is relatively harmless and that most babies who develop it won’t face any additional problems. The fact is, however, that if jaundice is unmonitored, it can lead to serious medical complications, such as kernicterus, a rare type of brain damage.
It is important to understand the risks surrounding jaundice, including Kernicterus, and what treatment options are available for your infant.
What is Kernicterus?
Kernicterus, also known as Hyperbilirubinemia, is a rare neurological disorder that occurs when hyperbilirubinemia damages the brain. Bilirubin is the yellow pigment seen on babies with jaundice. The yellowish color comes from bilirubin’s yellow pigment. As the body breaks down excess red blood cells (a normal process), bilirubin is released into the bloodstream, which causes the skin and whites of the eyes to appear yellow.
What Causes Kernicterus?
Kernicterus is most often the result of hyperbilirubinemia, or excess levels of bilirubin in the bloodstream. When bilirubin levels get too high, it can enter brain tissue and cause brain damage.
Can Kernicterus be Prevented?
Although in many cases, there is no known way to discern which infant will develop jaundice severe enough to cause Kernicterus, babies with Rh hemolytic disease are at a heightened risk. Rh hemolytic disease causes fetal blood cells to cross the placenta and enter the mother’s bloodstream. The mother’s body forms antibodies against the foreign invaders, which causes destruction of fetal blood cells when the blood crosses back into the placenta.
In response to the destruction of red blood cells, the fetus’ bone marrow will release immature red blood cells. The hemoglobin from the destroyed cells breaks down into bilirubin. Generally, bilirubin is broken down by the mother during pregnancy. Rh hemolytic disease can compromise this process leading to abnormally high levels of bilirubin at birth.
Symptoms of Kernicterus
Kernicterus symptoms will greatly depend upon if it’s in an early or later stage of the disorder.
Symptoms associated with the early stage include:
- Poor feeding and sucking
- Excessive jaundice
- Fatigue and lethargy
As the condition progresses, symptoms may include:
- High-pitched shrieks and cry
- Bulging on the infant’s “soft spot” (fontanel)
As Kernicterus reaches the most severe stage, symptoms may include:
- Hearing loss (high-frequency)
- Vision loss
- An increase in seizures
- Muscle stiffness and problems with movement
How Does Kernicterus Affect Children?
It’s extremely important that healthcare providers monitor jaundice, especially within the first 24 hours of the condition developing. Along with the aforementioned symptoms, Kernicterus can lead to a number of neurological disorders, some slight such as minor learning disabilities, and some as serious as athetoid cerebral palsy. Other risks and complications include complete hearing loss, and even death.
Treatment for the condition depends on the age of the baby (in hours) and what the level of bilirubin actually is. phototherapy might be something you want to discuss with your doctor if the baby has high levels of bilirubin, but if the baby has had high levels of bilirubin for a while, your doctor is likely to start the process of exchange transfusions, getting more normal-celled blood into the baby’s system as soon as possible.
How is Kernicterus a Birth Injury?
Some people think that birth injuries are mistakes made at the child’s birth that affects him or her for a lifetime –or at least for a few years. While this is generally true, Kernicterus may qualify as a birth injury if a physician fails to detect and monitor the high levels of bilirubin.
While no parent or doctor could have caused Kernicterus in the baby,it’s the doctor’s responsibility to treat the condition before it escalates. Mistreatment of this condition could result in brain damage that will change the infant’s life forever.