When does kernicterus occur in neonates?

In some cases, symptoms and physical findings of kernicterus appear two to five days after birth. Within the first few days of life, affected infants develop abnormally high levels of bilirubin in the blood (hyperbilirubinemia) and persistent yellowing of the skin, mucous membranes, and whites of the eyes (jaundice).

What causes kernicterus in newborn?

Kernicterus is a rare but serious complication of untreated jaundice in babies. It’s caused by excess bilirubin damaging the brain or central nervous system.

At what level does kernicterus occur?

Kernicterus, or bilirubin encephalopathy, is bilirubin-induced neurological damage, which is most commonly seen in infants. It occurs when the unconjugated bilirubin (indirect bilirubin) levels cross 25 mg/dL in the blood from any event leading to decreased elimination and increased production of bilirubin.

Why are infants at risk for kernicterus?

Kernicterus is caused by severe jaundice that isn’t treated. Jaundice is a common problem in newborns. It happens because a newborn’s liver can’t process bilirubin quickly enough. Bilirubin builds up in the baby’s bloodstream as a result.

How common is kernicterus in newborn?

Kernicterus only affects about 1 in 44,000 newborns in developed countries because jaundice is usually treated before it becomes dangerous. Symptoms of kernicterus include excessive sleepiness, high-pitched crying, muscle spasms and arching in the neck and back.

What are the signs of kernicterus?

Symptoms of kernicterus can vary, but may include:

• Drowsiness or lack of energy.
• Uncontrollable or very high-pitched/shrill crying.
• Fever.
• Trouble feeding.
• Limpness or stiffness of the whole body.
• Unusual eye movements.
• Muscle spasms or reduced muscle tone.

Can breastfeeding jaundice cause brain damage?

However, if breastfeeding jaundice is not diagnosed and left completely untreated it can potentially advance into a dangerous condition called kernicterus. If jaundice develops into kernicterus it can seriously and permanently damage a baby’s brain.

Does hyperbilirubinemia damage the brain of healthy full term infants?

No baby should develop brain damage from untreated jaundice.

What is kernicterus?

Kernicterus is a rare but irreversible brain damage that can result from high levels of bilirubin in a baby’s blood being deposited in baby’s brain tissue. Kernicterus is usually seen only in infants with untreated jaundice, and it very rarely occurs in adults.

What are the symptoms of kernicterus in babies?

Initial symptoms of kernicterus in babies include: 1 decreased awareness of the world around them – for example, they may not react when you clap your hands in front of their face. 2 their muscles become unusually floppy, like a rag doll. 3 poor feeding.

What is the risk for kernicterus toxicity in infants?

Above this level, the risk for toxicity progressively increases 56). More than three-quarters of the infants in the United States’ kernicterus registry (between 1992 and 2002) had a total serum bilirubin concentration of 515 µmol/L or greater, and two-thirds had a concentration exceeding 600 µmol/L 57).

What is the prevalence of kernicterus?

Kernicterus is the pathological finding of deep-yellow staining of neurons and neuronal necrosis of the basal ganglia and brainstem nuclei 1). The incidence of kernicterus in the USA is estimated to be 1 in 40,000 births, with about 1 in 650 to 1000 neonates born >35 weeks’ postmenstrual age experiencing transient hyperbilirubinemia (>25 mg/dL) 2).