a very rare type of brain damage that occurs in a newborn with severe
jaundice. It happens when a substance in the blood,
bilirubin, builds up to very high levels and spreads
into the brain tissues. This causes permanent brain damage.
Kernicterus may be prevented by treating jaundice early before it gets
By Janis Graham
Stuffing? Check. Stiff drinks? Check. Stress? Check. 'Tis the season -- for
stomachaches. "The holidays create a perfect storm for stomach problems because
of all the eating, traveling, and partying," says Roger D. Mitty, M.D., chief
of gastroenterology at Caritas St. Elizabeth's Medical Center in Boston. And
women are especially vulnerable, since some gastrointestinal ills occur up to
six times more often in women than in men. What's more, a recent survey found
Kernicterus is caused by
a high level of bilirubin in a baby's blood. If left untreated, the bilirubin
can then spread into the brain, where it causes long-term damage.
A low-level buildup of bilirubin is normal. This is called mild jaundice,
and it gives a newborn a slightly yellowish tint to the skin and sometimes the
Normally, extra bilirubin is removed from the bloodstream
by the liver and kidneys, and it leaves the body in urine and stool. During
pregnancy, the mother's body removes the extra bilirubin for the baby. After
birth, it takes a few days for the newborn's liver to get good at removing
bilirubin from the blood. If you feed your baby every 2 to 3 hours, mild
jaundice will usually go away on its own after a few days. But if your baby has
any signs of jaundice, you and your doctor will need to watch him or her
If jaundice continues to get worse and is not treated,
bilirubin in the blood can build up to a high level. This is when kernicterus
becomes a concern. It may be that some babies have health problems that make
them more likely to have bilirubin levels that climb to high levels. For
example, hemolytic disease, in which a
mother's Rh blood factor is not compatible with her baby's, can make a baby produce more bilirubin than normal. Intestinal
blockages can make it harder for a baby to remove bilirubin.
What are the symptoms?
Kernicterus has likely
already started if a baby has certain symptoms, including:
Extreme sleepiness and lethargy. This means a
baby is difficult to wake up from sleep or can't be kept awake. But keep in
mind that newborn babies sleep a lot. Lethargy in a newborn is easy to confuse
with normal newborn behavior. A lethargic baby does not eat well, does not
respond to touching or does not startle from sudden movements, and never seems
to fully wake up.
A very high-pitched cry that does not sound
Poor muscle tone. The baby may seem "floppy" and weak.
Sometimes this is followed by periods when the baby's muscles flex in a way
that is not normal. The baby may be stiff and arch his or her back and head.
fever that occurs along with any of these other
The lifelong damage from kernicterus may cause long-term:
Movement problems. A baby may develop slow
and uncontrolled movements or random, jerky movements.
or deafness. Some babies may seem to have normal hearing, but they develop a
problem processing sounds. This is called auditory neuropathy or auditory