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Jaundice / Kernicterus - FAQs
Kernicterus > FAQs

Frequently Asked Questions about Jaundice and Kernicterus

 

What causes jaundice?
Jaundice can develop when red blood cells break down and bilirubin is left. It is normal for some red blood cells to die every day. In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s liver must remove the bilirubin. In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice.

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What are some of the signs of jaundice?
Jaundice usually appears first on the face and then moves to the chest, belly, arms, and legs as bilirubin levels get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. Your baby’s doctor or nurse can test how much bilirubin is in your baby’s blood.

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Are some babies more likely to be jaundiced?
About 60% of all babies have jaundice. Some babies are more likely to have severe jaundice and higher bilirubin levels than others. Babies with any of the following risk factors need close monitoring and early jaundice management:

Sibling
A baby with a brother or sister that had jaundice is more likely to develop jaundice.

Feeding difficulties
A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice.
 

Bruising
A baby who has bruises at birth is more likely to have jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to look black and blue. Then, when the bruise begins to heal, red blood cells die. Bilirubin is made when red blood cells break down. The healing of large bruises may cause high levels of bilirubin, and the baby may become jaundiced. 

Early jaundice
A baby who is yellow in the first 24 hours of life may get dangerously jaundiced.

Heredity 
A baby born to an East-Asian or Mediterranean family is at a higher risk of becoming very jaundiced. Also, jaundice is harder to see in babies with darker skin tones. Some families inherit conditions (such as G6PD), and their babies are more likely to become jaundiced.
 

Preterm babies
Babies born before 37 weeks, or 8 ½ months, of pregnancy may become jaundiced because their liver may not be fully developed. The young liver may not be able to get rid of so much bilirubin. If too many red blood cells break down at the same time, the baby can become very yellow or may even look orange.

 

Blood type
Women with an O blood type or Rh negative blood factor might have babies with higher bilirubin levels. A mother with Rh incompatibility should be given Rhogam.

 

 
























 

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Does jaundice always cause a problem?
Many babies have some jaundice. Jaundice can develop when red blood cells break down and bilirubin is left. It is normal for some red blood cells to die every day. In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s liver must remove the bilirubin. In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice. The yellow color does not hurt the baby's skin, but the bilirubin goes to the brain as well as to the skin. When severe jaundice goes untreated for too long, it can cause brain damage and a condition called kernicterus.

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What is kernicterus?
Kernicterus is a type of brain damage that causes athetoid cerebral palsy and hearing loss. It also causes problems with vision and teeth and sometimes can cause mental retardation.

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Who can develop kernicterus?
Any baby with untreated jaundice is at risk for kernicterus. This does not mean that every baby with yellow skin will have brain damage. Most babies with jaundice get better by themselves. If their skin is very yellow, they might need phototherapy treatment. If phototherapy does not lower the baby's bilirubin levels, the baby may need an exchange transfusion. 

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What are some warning signs of kernicterus?

 Ask your pediatrician to see your baby the day you call, if your baby

ü                    Is very yellow or orange (skin color changes start from the head and spread to the toes)

ü                    Is hard to wake up or will not sleep at all

ü                    Is not breastfeeding or sucking from a bottle well

ü                    Is very fussy

ü                    Does not have at least 4 wet or dirty diapers in 24 hours

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Can jaundice be treated and prevent kernicterus from developing? 

No baby should develop brain damage from untreated jaundice. If a baby gets too jaundiced, the baby can be treated with phototherapy. That is, the baby can be put under blue lights most of the day. The blue lights do not bother the baby. They are warm and probably feel good. If the baby gets very, very jaundiced, the doctor can do an exchange transfusion. 
Click here to read more more...

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What should I do if I think my baby has jaundice?
Call and visit your baby's doctor right away. 

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Is there a support group for parents of infants and children with kernicterus? 

Yes. Parents of Infants and Children of Kernicterus parents of Infants and Children with Kernicterus

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What does the American Academy of Pediatrics say about jaundice?
Question and Answers: Jaundice and Your Newborn


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DISCLAIMER: Links to organizations outside of CDC are included for information only. CDC has no control over the information at these sites. Views and opinions of these organizations are not necessarily those of CDC, the Department of Health and Human Services (HHS), or the U.S. Public Health Service (PHS).

Date: March 28, 2007
Content source: National Center on Birth Defects and Developmental Disabilities

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