Kernicterus is a complication of severe jaundice. It happens when a waste product collects in your child’s blood and brain tissue. Sixty percent of infants experience yellowing of their skin and eyes during the first few weeks of life. Severe complications are rare, but can be life-threatening.
Kernicterus is a rare condition that affects your baby’s brain when they have too much bilirubin in their blood (hyperbilirubinemia). Bilirubin is a yellow waste product that your body makes. Sometimes, your liver can’t remove enough bilirubin to keep you healthy. Too much bilirubin can cause jaundice. This is when your skin, the whites of your eyes and your gums or the area underneath your tongue (mucous membranes) appear yellow.
Symptoms of kernicterus progress in stages. In addition to jaundice, symptoms usually affect newborns and include irritability, poor feeding and seizures. Complications can lead to hearing loss and permanent brain damage. If you notice changes to your newborn’s behavior or appearance, contact their healthcare provider immediately.
You may hear your healthcare provider call kernicterus “bilirubin encephalopathy.”
Jaundice is common in newborns. Healthcare providers will monitor newborn jaundice to decrease your baby’s risk of developing kernicterus, which is why the condition is rare.
While the condition most often affects newborns, rare cases may affect adults.
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The first sign of kernicterus is jaundice. If your baby has jaundice, the following parts of their body will have a yellow tone:
Healthcare providers may diagnose this condition one to three weeks after birth.
In addition to jaundice, signs of kernicterus may include:
Other signs and symptoms of kernicterus vary based on the stage of the condition.
There are three stages of kernicterus, each with different symptoms.
Late-stage kernicterus is very serious and life-threatening. If you notice your child has jaundice in addition to any other symptoms, contact their healthcare provider immediately.
Very high levels of bilirubin in your blood (hyperbilirubinemia) cause kernicterus. This happens when your newborn’s liver can’t get rid of enough bilirubin.
Causes of hyperbilirubinemia may include:
When your liver isn’t able to get rid of bilirubin through your poop, it collects in your blood before moving into your brain tissue. Bilirubin in your brain can cause severe complications.
Complications of kernicterus can be life-threatening and include:
Your newborn is more at risk of developing kernicterus if they:
Children who are healthy may develop jaundice. Severe jaundice can lead to kernicterus.
A healthcare provider will diagnose kernicterus after a physical exam and testing. Two tests include:
A light meter is a device that shines a medical-grade light on your baby’s skin. It calculates a bilirubin level based on how the light reflects off of your baby’s skin onto the device.
To confirm a diagnosis, a healthcare provider will perform a bilirubin blood test. For this test, a healthcare provider will remove a small sample of blood from your newborn’s heel. A lab will run the test to determine how much bilirubin is in your child’s body.
A healthcare provider will measure the total serum bilirubin (TSB) level in your baby’s blood to diagnose kernicterus. A normal TSB level is 0.1 to 1.2 mg/dL (milligrams per deciliter). Symptoms of jaundice appear when your TSB level is 2.0 mg/dL. A test result of 25 mg/dL or more is very high and leads to a kernicterus diagnosis. If you’re unsure about test results, contact your healthcare provider.
Treatment for kernicterus can include:
It could take up to two weeks before your child feels better. If your child has late-stage symptoms that affected their brain, complications are irreversible. Treatment and support are available to help your child adapt if complications do arise as they grow.
You can help your child feel better sooner by making sure they get enough to eat. A newborn may have feeding difficulties if they have kernicterus. A healthcare provider can give you instructions on how you can help your child get the nutrients they need if they’re not feeding well. Your child needs to meet their feeding requirements so they can poop. Passing stool helps move waste products like bilirubin out of your newborn’s body.
There isn’t a way to prevent all causes of kernicterus. You can reduce your child’s risk of developing kernicterus by:
If your child receives treatment for kernicterus while the condition is in the early or middle stage, your newborn may make a full recovery. Babies who have late-stage kernicterus may have complications that can be life-threatening. Talk to your child’s healthcare provider to learn more about your child’s outlook.
In most cases, a healthcare provider will diagnose newborn jaundice and treat it before it can worsen and develop into kernicterus.
If diagnosed and treated quickly, a baby can make a full recovery from kernicterus. Your child’s prognosis varies depending on the stage of the condition and what caused it.
Contact a healthcare provider if you notice your newborn has a yellow tone to their skin, the whites of their eyes or in their mouth within the first few weeks of their life. While jaundice is common for newborns, extremely high levels of bilirubin can be life-threatening. A healthcare provider will examine your child and test their bilirubin levels to make sure they’re healthy.
If your child has jaundice and develops other symptoms of kernicterus, like a seizure, contact 911, your local emergency services or go to an emergency room immediately. Other emergency symptoms to look out for include:
A note from Cleveland Clinic
As a newborn’s parent or caregiver, it can be worrisome to see that your child has a yellow tone to their skin and eyes. It can also be difficult to watch your child experience symptoms that you’re unable to control or fix. While jaundice is very common, kernicterus — a severe complication of jaundice caused by too much bilirubin in your child’s blood — isn’t. If something doesn’t seem right, contact your child’s healthcare provider and be their advocate. While complications are possible after kernicterus, lifelong support is available to help your child grow and learn. When diagnosed and treated early, your newborn can get back to good health.
Last reviewed by a Cleveland Clinic medical professional on 05/30/2023.
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