Jaundice and Cerebral Palsy

Fact Checked

There is a common misconception that jaundice isn’t a severe condition and that, eventually, it will clear up on its own. While that may be true in some instances, in other cases, a severe case of jaundice can lead to brain damage, which can cause cerebral palsy in an infant. With quick treatment, jaundice is reversible and causes no harm.

What Is Jaundice?

According to the Centers for Disease Control and Prevention (CDC), jaundice is a medical condition marked by a yellowish tint to a newborn’s skin.

Jaundice occurs when bilirubin accumulates in a baby’s blood. Bilirubin is a yellow substance created when older red blood cells break down.[1]

Newborns produce more red blood cells when compared to adults, which results in a higher turnover of the blood cells, leading to jaundice. Usually, bilirubin is eliminated via bowel movements or broken down in the liver. A newborn baby’s liver (especially those born prematurely) is still developing and is less effective in removing bilirubin.

Around 60% of all infants born in the United States have jaundice.[1] While some infants have mild cases, the babies with high bilirubin levels must be monitored closely as untreated jaundice can lead to severe medical problems and, in some cases, death.

Types of Jaundice in Newborns

“Normal” Jaundice: Many newborns will have at least some jaundice while their liver continues to develop. Mild jaundice usually disappears within a few weeks after birth, but it’s always important to have your baby’s pediatrician rule out any medical concerns.

Breastfeeding Jaundice: Some breastfed babies may develop jaundice. This generally occurs when an infant doesn’t get enough breast milk, as the mother’s breast milk isn’t entirely in yet. This isn’t the same as breast milk jaundice since the jaundice isn’t a result of breast milk.

Premature Infant Jaundice: Jaundice is more common in premature babies since their livers are less developed than a full-term baby.

Breast Milk Jaundice: This type of jaundice occurs when breast milk substances make bilirubin levels rise. This form of jaundice is rare, only accounting for around 1% to 2% of newborns. It generally occurs within a week after birth and subsides within a few weeks. The exact cause of breast milk jaundice isn’t known, but scientists suspect it has something to do with a substance in the mother’s milk that stops the baby’s liver from breaking down bilirubin properly.

Blood Incompatibility: Blood incompatibility between mother and baby can also cause the infant to develop jaundice. The mother’s blood may produce antibodies that cause the baby’s blood cells to break down into bilirubin. This, in turn, causes bilirubin to build up.

Symptoms of Jaundice in a Newborn

Jaundice usually appears shortly after birth, and the yellowish tint is more easily detectable in infants with light skin shades. It can appear all over the face, as well as the arms, legs, stomach, neck, head, and toes.

Other symptoms include:

• Difficult to wake up or difficulties falling asleep
• Lack of wet diapers
• Unusual fussiness
• Yellow or orange skin color

Jaundice and the Risk of Kernicterus and Brain Damage

If jaundice is severe and left untreated, babies are in danger of developing kernicterus, a rare form of brain damage that occurs when bilirubin builds up to extremely high levels and enters the brain. Kernicterus is also known as bilirubin encephalopathy.

Kernicterus is a life-threatening neurological condition that typically develops within the first week of life. If an infant develops kernicterus, a host of other associated disorders may follow, including brain damage, cerebral palsy, and hearing loss. It can even be fatal.[2]

If your baby exhibits any of the following symptoms associated with kernicterus, seek medical help immediately:

• Unresponsive
• Still or limp body movements
• High-pitched crying while arching the back

There are three stages of kernicterus:

Stage One:

• Difficulties with feeding/poor feeding
• Acute jaundice
• Hypotonia
• Lethargy

Stage Two:

• Seizures
• A bulge in the infant’s fontanel (the “soft spot” on the baby’s head)
• Hypertonia
• Extremely high-pitched crying

Stage Three:

• Seizures
• Difficulties with moving (movement disorders)
• Hearing loss (high-frequency)
• Mental/Intellectual issues
• Speech problems
• Rigid muscles

In severe cases, especially if treatment doesn’t begin as soon as possible, kernicterus can lead to death.

Treatment Options

If an infant has high bilirubin levels, physicians will generally put the baby under specialized lighting (light therapy or phototherapy) to reduce the levels.

Phototherapy facilitates the breakdown of bilirubin in the skin. A blood exchange procedure may be performed if the bilirubin levels are very high.[3]

What Are the Risk Factors for Newborn Jaundice?

Babies born prematurely have the highest rates of developing jaundice and kernicterus. Other risk factors include blood type incompatibilities, prematurity, maternal infections, and birth trauma.[3]

Medical neglect caused by physicians and other professionals can also lead to kernicterus. The following instances are examples in which healthcare professionals act negligently, which can cause brain damage and other medical issues:

• Stalling or postponing jaundice treatment
• Failure to remove red blood cells in time (exchange transfusion)
• Failure to have safety measures for bilirubin in place at medical centers or hospitals
• Failure to examine, diagnose, and treat jaundice or bilirubin promptly
• Failure to diagnose blood incompatibility between the infant and the mother

Unfortunately, some babies have developed kernicterus and cerebral palsy at the hands of negligent physicians and medical staff. If your baby was injured due to medical negligence, remember that you have the legal right to file for damages against the responsible party.

Things to Remember About Jaundice

Even if your baby’s jaundice seems mild, never assume it will go away without treatment. It’s always a good idea to check with your baby’s doctor. Keep in mind that it’s hard to determine if the jaundice is severe by just looking at your baby.

Additionally, it’s more difficult to see jaundice on infants with darker skin, but if you press your hand on your baby’s skin and the area turns yellowish, this may indicate that your infant has jaundice.

Call your baby’s doctor right away if:

• The jaundice seems to be spreading.
• Your baby seems unusually fatigued.
• Your baby stops feeding or begins to have poor feeding.
• Your baby has a fever of over 100°F (37.8°C).

Talk to a lawyer if your child had undiagnosed jaundice and a delay in treatment. You might be eligible to make a claim for compensation.