After a baby is born, the red blood cells die off and a substance called billirubin is formed as the dead cells break down in the blood stream. Under normal circumstances, the liver does a good job of breaking down billirubin. Sometimes, in the first few days of life, a newborn's immature liver cannot break down the billirubin as quickly as necessary. When the billirubin builds up, the baby can appear to have a yellowish tint to his skin. This is jaundice. Phototherapy is often used to treat jaundice, usually with complete success. Sometimes blood transfusions are necessary as well.
The symptoms of kernicterus include:
- Extreme jaundice
- Poor feeding
- Absent stares
- Bulging at the soft-spot
- High pitched crying, arching the back
Kernicterus is a devastating condition with a generally poor outcome. High levels of billirubin can be caught with routine monitoring. Adequate testing of billirubin levels can help prevent this preventable condition in newborns. Doctors must test the direct billirubin level, not relying on the indirect level to diagnose dangerous levels.
The American Academy of Pediatrics recommends that newborns be screened for billirubin levels within the first 24 hours of life. Follow-up screenings within the first two or three days after they leave the hospital are further recommended for all babies, especially premature infants.
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