Medical changes that could prevent brain damage in infants

By Allison G. S. Knox, EMT-B, Faculty Member at American Military University

It isn’t rare for newborn babies to have trouble with jaundice in the days after their birth. The condition is usually recognizable by an orange coloring of the skin, which is caused by a high level of bilirubin in the blood. Most of the time the baby’s liver will rid the body of bilirubin, but in rare cases, the bilirubin level rises so quickly that their body simply cannot recover, resulting in devastating effects.

When the level is high enough, bilirubin crosses the blood-brain barrier and leaves a stain on the brain that causes brain damage, a condition called kernicterus. Untreated severe hyperbilirubinemia can also cause auditory neuropathy spectrum disorder, ranging from mild to complete hearing loss, and cerebral palsy, which leaves a child unable to walk. Many of these children are forced into wheelchairs for life. For some, severe hyperbilirubinemia can even result in death. Once caused, the damage from hyperbilirubinemia cannot be reversed, but the cognitive parts of the brain are often left intact. For the family of a child with kernicterus, it can be devastating to see their child who was perfectly healthy at birth suddenly suffer from a debilitating illness.

Changing medical policies
To effectively manage jaundice and detect hyperbilirubinemia in newborn babies, healthcare policies are in urgent need of change. Because potentially devastating levels of bilirubin are so rare, many doctors don’t necessarily look out for the signs and symptoms that can arise in the first few days of a newborn’s life. As a result, a child who could be helped is often left untreated. If bilirubin levels were regularly checked through physician-ordered tests, fewer babies would suffer from kernicterus.

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