What
is Kernicterus?:
When too much of the bilirubin protein deposits in the brain
tissue of a newborn, it may result in a type of brain damage
called Kernicterus. This particular type of damage is associated
with neurological impairment including cerebral palsy (an
inability to control muscle movement of the face, body,
arms, and legs). It has also been associated with deafness,
learning disabilities and other conditions.
Who is at risk?:
All newborn babies are at risk to suffer from Jaundice.
Males are more prone to abnormal levels of bilirubin, as
are breast fed babies, and those of Asian decent. Premature
babies are at greater risk for the bilirubin protein to
deposit in the brain tissue, even at lower levels.
How
is Jaundice diagnosed and monitored?:
It is a standard within the medical community that all newborns
should have their bilirubin levels tested at least once
after their birth before they are discharged from the hospital.
This is achieved with a simple blood test, and, often picks
up slightly abnormal levels in bilirubin. Abnormal test
results should alert healthcare providers to closely monitor
the baby while still admitted, and, provide proper instructions
to parents upon the child’s discharge from the hospital,
specifically with regard to the dangers and signs of Jaundice.
Discharge instructions should also include follow-up appointment
information. For example, the standard of care requires
instructions to new parents whose child is released from
the hospital in less than 48 hours after birth to see a
pediatrician within two days of discharge. In addition,
a newborn’s activity and coloring should be carefully
observed by healthcare providers in and out of the hospital,
as well as by parents and other family members, to see if
there is any noticeable yellowing of the skin, or, an increase
in this coloration. Typically, this yellowing starts at
the top of the head, and as bilirubin levels increase, the
complexion may become more severe and extend down the face,
neck and trunk. It is critical that parents immediately
bring any abnormalities with regard to their newborn’s
complexion to the attention of healthcare providers.
How
is Jaundice treated?:
If Jaundice is observed in the hospital, it is often treated
by simply placing the child under UV (ultraviolet) lights.
Once Jaundice is diagnosed, bilirubin levels may be monitored
to ensure that they drop. In the hospital repeat blood work
is also a simple matter. If the child has already been discharged
from the hospital, monitoring is done most accurately by
virtue of repeat blood tests within a day or 2 of the newborn’s
discharge, or within a day or 2 of the diagnosis. If the
protein levels are found to be dropping, then typically
no treatment is required. If levels continue to rise, the
baby may need to be kept in the hospital or re-admitted
for either UV therapy, or if the condition is severe enough,
for blood transfusion therapy as well. In cases of mild
Jaundice, healthcare providers often recommend that a newborn
who is discharged be placed near a window at home, where
they are exposed to natural light. This “home remedy”
can help babies with slight jaundice to normalize
their protein levels as they are exposed to the UV rays
contained within natural light. Some doctors recommend that
breast feeding be stopped until bilirubin levels normalize.
If diagnosed
in a timely manner, Jaundice is easily treatable and, and
if so, very rarely results in a child suffering from injury.
However, if healthcare providers, including nurses and pediatricians,
fail to timely recognize the signs and symptoms of Jaundice,
and further, fail to timely perform proper tests and follow-up
examinations, this condition may not be diagnosed in time
to prevent its effect on the newborn brain (Kernicterus).
Likewise, if treatment is delayed or is insufficient to
treat the condition, Kernicterus may occur.
Blume
Goldfaden has represented numerous neurologically impaired
children and their families in cases where there was a failure
to properly diagnose and/or timely treat hyperbilirubinemia.
If you have any questions about your child, please feel
free to call or e-mail, and one of our attorneys will be
happy to speak with you free of charge.
