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Jaundice / 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.
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.
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:
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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.
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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.
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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.
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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. |
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.
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.
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.
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)
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Is hard to wake up or will not sleep at all
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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
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.
more...
What should I do if I
think my baby has jaundice?
Call and visit your baby's doctor right away.
Is there a support group
for parents of infants and children with
kernicterus?
Yes. Parents
of Infants and Children of Kernicterus 
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:
February 04, 2009
Content source: National Center on Birth Defects
and Developmental Disabilities |
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