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Elevated Bilirubin Levels and Kernicterus in Infants

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Bilirubin is a substance found in the bile of infants.  Bile helps the body digest fats, is produced by the liver, and released into the small intestine to help with the digestion.  A small amount of bile is released into the stool and must therefore be replaced by the liver.  When the liver breaks down old red blood cells, it produces bilirubin, which is then removed from the body through the stool. Elevated bilirubin levels may be an indicator that a baby is in danger of getting certain diseases such kernicterus.  A bilirubin test will measure the amount of bilirubin in a blood sample.

If bilirubin levels rise slightly, this is usually not a problem.  In fact within the first 24 hours after birth, nearly half of all newborns have elevated bilirubin levels.  This is because newborns do not have a liver that is mature enough to break down the excess red blood cells they are born with.  However a high level of bilirubin can cause hearing loss or eye movement problems, mental retardation, and eventually if left untreated, can lead to kernicterus. 

Kernicterus is a form of brain damage that occurs by a high level of bilirubin in an infant's blood.  Elevated bilirubin levels can be caused by severe jaundice which is a yellowing of the skin and eyes of a newborn which may be detected within days of birth.  Severe jaundice can be treated with special lights, phototherapy, or a blood transfusion.

Kernicterus warning signs to pay attention to:

  • The baby has an abnormally high pitched cry
  • The baby is lethargic and extremely sleepy
  • The baby does not respond to touching or startles from sudden movements
  • The baby has poor muscle tone
  • The baby suffers from seizures
  • The baby has a fever


Long term disabilities resulting from kernicterus:

  • Movement difficulties
  • Hearing loss or deafness
  • Problems moving the eyes
  • Learning problems

These problems are an important reason why parents need to pay attention to elevated bilirubin levels and jaundice in their newborns.  In the case of kernicterus, prompt treatment may help prevent additional brain damage from occurring.  Treatment for kernicterus includes speech therapy, physical therapy, and special education. 

If you discover your child has kernicterus, you should consult with a birth injury attorney like Dr. Bruce Fagel.  If the kernicterus could have been prevented, you may have a case for medical malpractice. Visit Kernicterus Video for an informative video.