Neonatal Jaundice

What is jaundice?

Jaundice is one of the most common conditions needing medical attention in newborn babies. Jaundice refers to the yellow colouration of the skin and is caused by a raised level of bilirubin in a baby’s bloodstream. Bilirubin is a brownish yellow substance which is produced by the liver to break down old red blood cells. Jaundice is common in newborn babies because babies have a high level of red blood cells in their blood. In addition, the liver in newborn babies is also not fully developed and so it is less effective at removing bilirubin from the blood.

Who is affected?

Approximately 60% of term and 80% of pre-term babies develop jaundice in the first week of life. However, only around 1 in 20 babies has a high enough level of bilirubin in their blood to actually need treatment.

Symptoms of jaundice

The yellowing of the skin usually starts on the head and face before spreading to the chest and stomach. In some babies the yellowing reaches their legs and arms.

Other associated symptoms of newborn jaundice can include: –

• Poor sucking or feeding
• Sleepiness
• A high-pitched cry
• Limpness (floppiness)
• Dark, yellow urine (a newborn baby’s urine should be colourless)
• Pale stools (faeces) instead of yellow or orange stools

Diagnosing jaundice

All babies should be checked for jaundice within 72 hours of being born. However, it can sometimes take up to a week to appear.

A visual examination will be carried out to look for signs of jaundice.

If it is thought that a baby may have jaundice the level of bilirubin should be tested. This can be done using a small device called a bilurubinometer or a blood sample using obtained by pricking the baby’s heel with a needle.

The level of bilirubin detected in a baby’s blood is used to decide whether or not treatment is necessary.

Treating jaundice

Treatment is only recommended if tests show a baby has a very high level of bilirubin in their blood because there is a small risk in these cases that the bilirubin could pass into the brain and cause brain damage (see below).

There are 2 main treatments that can be carried out in Hospital to quickly reduce a baby’s bilirubin levels. These are: –

• Phototherapy – a special type of light shines on the skin which alters the bilirubin into a form that can be more easily broken down by the liver;
• Blood transfusion – where small amounts of the baby’s blood are removed and replaced with blood from a matching donor.

Most babies respond well to treatment and can leave hospital after just a few days.

Are there are complications?

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

In newborn babies with very high levels of bilirubin in the blood the bilirubin can cross the thin layer of tissue that separates the brain and the blood. The bilirubin can damage the brain and spinal cord which can be life threatening.

Brain damage caused by high levels of bilirubin is also called bilirubin encephalopathy.

Initial symptoms of kernicterus in babies include: –

• Decreased awareness of the world around them – for example they may not make any reaction when a person claps their hands in front of the baby’s face
• Their muscles become unusually floppy like a rag doll (hypotonia)
• Poor feeding

As kernicterus progresses additional symptoms can include seizures and arching of the neck and/or spine.

Treatment for kernicterus involves a blood transfusion.

If significant brain damage occurs before treatment a baby can develop serious and permanent problems such as: –

• Cerebral palsy
• Hearing loss
• Learning difficulties
• Involuntary twitching of different parts of their body
• Problems maintaining normal eye movements.

Can I claim compensation?

If there is a delay in treatment a baby may soon become very ill.

If medical professionals do make errors there may be a case of medical negligence. This is usually as a result of: –

• Failing to carry out the necessary tests

• Delay in diagnosis

• Failing to provide appropriate treatment.

How can we help?

At Novum Law we offer free initial advice on claims of this kind. If you believe that you or any member of your family have a potential claim then let us assess your case. You can rest assured that we will deal with your enquiry without any initial cost or obligation.

To book a free, no obligation chat with us call 0800 884 0777, email info@novumlaw.com or complete our online enquiry form.