What is kernicterus?
Kernicterus is a form of brain damage that occurs as a result of jaundice in a newborn baby becoming so severe that bilirubin – a substance responsible for the yellowing of the skin and eyeballs – crosses the membrane of the brain, causing permanent damage.
High levels of bilirubin (hyperbilirubinemia) can be caused by the breakdown of red blood cells or the inability of a newborn baby’s liver to process and clear bilirubin properly. It is a particular risk for babies who are born prematurely.
Jaundice is very common in newborn babies, but is usually harmless, with symptoms clearing up without any need of treatment. In rare cases, it can be harmful to a child’s health, which is why it must be monitored carefully, especially if it appears within the first 24 hours of life. Bilirubin levels can be checked and assessed with a heel prick blood test.
If bilirubin levels begin to increase to a worrying amount, there are a number of treatment options available, including phototherapy or a blood transfusion, which can help bring bilirubin under control.
Various complications can arise as a result of kernicterus, including cerebral palsy, deafness, blindness, dental problems, issues with speech and language, and learning difficulties.
What are the symptoms of kernicterus?
The initial symptoms of kernicterus in babies include:
- Poor feeding
- A high-pitched cry
- Brief pauses in breathing (apnoea)
- Floppy muscles
As kernicterus progresses, additional symptoms can include seizures and muscle spasms that cause the back and neck to arch.
How can medical negligence contribute to kernicterus?
Kernicterus usually occurs due to medical negligence because of a lack of awareness of the risks of jaundice and a failure to perform prompt and regular checks and treatment by doctors, midwives or nurses.
Those most at risk to kernicterus include:
- Babies born prematurely
- Full-term babies with hyperbilirubinaemia
- Babies whose bilirubin levels are above the treatment threshold and are continuing to rise
- Newborn babies who develop jaundice in the first 24 hours after birth
- Babies with siblings who have suffered from hyperbilirubinaemia
- Babies who are solely breastfed