Kernicterus is a rare type of brain damage that occurs in newborns with severe jaundice. It causes athetoid cerebral palsy and permanent brain damage due to a substance in the blood called bilirubin, which builds to abnormally high levels and saturates brain tissue.
Jaundice is common in newborns that are born prematurely and usually goes away by itself. Sixty percent of newborns are affected by jaundice, which is the leading reason why newborns are readmitted into a hospital within a week of their new lives.
Symptoms include: yellow skin, the baby is hard to wake up or will not sleep at all, the baby is not breast feeding or sucking from a bottle well, the baby is constantly fussy and does not have regular wet diapers. Babies will appear limp or fragile and as the jaundice progresses a fever may develop and the baby may arch the head backwards into a very contorted position known as opisthotonus or retrocollis. Brain damage may already have occurred at this point – about three weeks into their lives.
Sometimes parents are told the early symptoms are only jaundice and the problem will go away on its own. As a result, new parents may overlook signs of a progressing problem and by the time symptoms become severe, Kernicterus has already caused brain damage and perhaps cerebral palsy.
In the last decade changes in jaundice management have shortened hospital stays and decreased concern about excessive jaundice and subsequent acute and chronic Kernicterus. Both parents and doctors should remain vigilant when jaundice is suspected because the disease can easily get out of control with devastating consequences.
Kernicterus clearly is preventable. With the right medical attention, from the beginning of a premature infant’s life, this condition can be completely avoided.