What Causes Jaundice Or A High Bilirubin to Turn Into Kernicterus?

Many times it is medical malpractice or doctor error that leads to kernicterus and permanent brain damage in a baby.

Kernicterus means "yellow kern" which is indicative of the part of the brain that is stained yellow. This yellowing occurs when a baby has hyperbilirubinemia or bilirubin encephalopathy. The sad thing is that kernicterus is a "never event" which means there is really no reason newborns should develop kernicterus but they still do. Why?

Bilirubin is made when the red blood cells are being broken down and eliminated. The waste product of the red blood cells is bilirubin. That is the yellow color that is eliminated in the urine, bowel movements, bile and other secretions. If a newborn can not keep up with the elimination of the bilirubin, it can accumulate in the body and cause the skin and eyes to look yellow. Jaundice in a newborn is not dangerous unless the bilirubin level is permitted to get to high and cross the blood-brain barrier causing damage to the baby's brain or kernicterus.

With the lab tests, phototherapy treatments and medical advances we have today, there is no reason a baby should develop kernicterus. If a newborn baby starts to show signs of an increased bilirubin or yellowing of the skin, they should be placed under phototherapy, bili-lights or a Wallaby bili-blanket. If those therapies do not work, the neonatologist or pediatrician need to further evaluate and treat the cause of the rising bilirubin level. Additional tests that may be performed are:

  • Hematologic studies or blood tests such as a complete blood count (CBC) and electrolyte studies
  • Total and direct bilirubin levels
  • Baby and mother blood types to check for ABO incompatibility or hemolytic hyperbilirubinemia or erythroblastosis fetalis
  • Reticulocyte count to see if there is an ongoing hemolytic or blood cell breakdown process
  • Direct Coombs test to check for antibodies on the red blood cell (RBC)
  • Lumbar puncture or spinal tap to rule out meningitis
  • Transcutaneous bilirubin measurement to measure total serum bilirubin levels through the skin and without any needle sticks

Pediatricians, doctors and neonatologists must promptly diagnose and treat a rising bilirubin level in a newborn before it is too late and permanent brain damage is done. If your baby had a high bilirubin level at birth or kernicterus please feel free to contact one of our experienced birth injury lawyers, doctors or nurses for a strictly confidential and free consultation. Kernicterus, brain damage or cerebral palsy due to a high bilirubin level is preventable and should not happen. Our specialized kernicterus teams consist of neonatal intensive care (NICU) nurses that have actual experience in monitoring and treating newborns with high bilirubin levels.

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