How to Spot Kernicterus in Newborns
Latest update: September 24, 2018
Author: Heidi Holvoet, PhD
Recognizing kernicterus in your newborn baby is
key to prevent severe brain damage. Symptoms of this excessive form of
jaundice are extreme sleepiness, crying with a high pitch and being
Now that sleepiness symptom may be a bit confusing ...
Most newborns are quite sleepy most of the time at first. And you may
be more than happy to enjoy these days and weeks in which she sleeps a
lot. Which is a good idea by the way, it helps you catch up on some
sleep after a possible tiring delivery.
But make a note of the list of symptoms below to look out for. You will
then spot anything excessive in time so your baby can be treated if
What is kernicterus?
It is the form of brain damage that can occur as a consequence of extreme jaundice.
The very common and usually harmless
jaundice in newborns - baby looks yellow - is caused by a substance called bilirubin.
If the levels become extremely high, the bilirubin can reach the brain
tissue and cause brain damage. That is what doctors call kernicterus.
How to recognize?
The typical symptoms of kernicterus are:
- Extreme sleepiness and lethargy
i.e. it is all the time difficult to wake up your newborn baby
completely. Or if she does wake, she seems to doze off again
This also means that it is difficult to
feed well. Partly, your baby will probably suckle a little, even while
asleep. But to take a full good feed, she must be awake for a while.
- A lot or little muscle tension. Baby has her muscles very tense (cramping up) or on the contrary not seem to have much muscle tension.
- Arching back and spine, lying in strange/unnatural positions.
- Crying a very high-pitched cry, i.e. screaming rather than crying normally.
Fever is of course very common and happens with so many issues, even a
simple virus can cause it. But for a newborn baby, fever is always a
sign to see your doctor right away, regardless of the possible cause.
What to do?
As soon as you suspect one or several of the above symptoms, you should
consult a doctor immediately. If your general practitioner or
pediatrician nearby is not available, go to the nearest hospital
If the symptoms are occurring, that means that damage is being done already.
But, as child neurologist Dr. S. M. Shapiro MD, MSHA stresses, that
does not mean that it's too late! The damage may still be reversed if
treatment starts quickly, and worse harm can be prevented.
Dr. Shapiro urges parents to avoid any delay in treatment, as he explains on Kernicterus.org.
To avoid any unnecessary damage, he prefers over-treatment rather than
treating too late. This means for example starting treatment while
still awaiting lab tests rather than wait until damage is already done.
Medical treatment will consist of intensive photo therapy (blue light)
and if need be a blood transfusion (to quickly get rid of the bilirubin
in the blood). As always, hydration is crucial so if necessary, baby
will be tube fed for a while.
Finally, as with all warning articles, please don't let this one overly
scare you. This is a rare condition which is not very likely to occur
for your baby. But it is is very important to be aware of its existence
and see a doctor if you recognize the symptoms.