Newborns need special care.  As their tiny bodies acclimate to the world outside of the protective environment of the womb, they must be monitored closely within the first few days of life.  Many Kansas City parents know to watch for the signs of jaundice in their newborns.  Sometimes, however, a normal condition like jaundice can transform into a more serious condition.

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. If, however, the amount of billirubin is allowed to build up too far, a dangerous condition called kernicterus occurs.  In the case of kernicterus, billirubin can enter the brain.  High levels of billirubin in the brain can cause devastating brain damage, or death.

The symptoms of kernicterus include:
  1. Extreme jaundice
  2. Poor feeding
  3. Absent stares
  4. Lethargy
  5. Seizures
  6. Bulging at the soft-spot
  7. 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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James Roswold
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James Roswold is a Kansas & Missouri personal injury, workers comp, and medical malpractice attorney.