Kernicterus is a preventable medical disorder that affects infants and arises when yellow jaundice is not diagnosed and treated appropriately. Failure to diagnose and treat this condition properly may result in a solicitors kernicterous compensation claim for personal injury. The name is from the Greek "kern" or kernal plus "icterus" or yellow. This condition usually results in the child suffering from cerebral palsy. The diagnosis is made following analysis of a sample of blood taken from a heel prick that measures the level of bilirubin in a baby's blood. If the bilirubin levels are too high a blood exchange may need to be performed in a hospital with that capability.

The "athetoid" form of cerebral palsy is classic in this condition. Athetosis refers to the slow, writhing involuntary movements that occur. Dystonia, or abnormal muscle tone and position, also occurs. Some children are deaf, some have normal hearing, and some with or without deafness have an auditory processing problem now called auditory neuropathy or auditory dys-synchrony. Auditory brainstem response (ABR) testing (also known as BAEP or BAER) is often abnormal, whereas other "hearing" tests, such as otoacoustic emissions (OAEs) and cochlear microphonic responses are normal. Symptoms may include:-

  • specific movement disorder
  • hearing loss or deafness
  • impairment of eye movements especially upward gaze
  • abnormal staining of the enamel of baby teeth


This condition is usually not diagnosed until the child is about 18 months old when athenoid cerebral palsy, hearing loss, and loss of upward gaze can be confirmed with specific MRI findings and a history of severe jaundice. Children who suffer from this condition often have normal intelligence and normal life expectancy however they must learn to sign and to use communication devices.

While most cerebral palsy is not caused by medical negligence the occurrence of kernicterus, particularly in a term, otherwise health baby is suggestive of medical negligence and most solicitors claims will therefore succeed and result in very substantial compensation payments.

About 4% of the babies born in Western Europe will have some type of birth injury which is damage caused to the baby's body before, during or shortly after delivery. About 10% of these injuries will have been caused by medical negligence and entitle the child, through their parents, to make a solicitors compensation claim against some or all of the healthcare professionals involved in the birth or in prenatal or postnatal care.

Kernicterus Solicitors

Proving a compensation claim in this area requires the skills of a specialist kernicterus solicitor who is well versed in cerebral palsy issues. Legal aid is available to pursue these claims with a nil contribution from the parents no matter the level of their salary, income or assets. Legal aid is only granted to children who are represented by lawyers who are members of the Solicitors Regulation Authority panel of clinical negligence experts. For free advice without further obligation from a kernicterus solicitor just call the helpline or use the contact form or email our solicitors offices. We will speak to you in plain English with no legal jargon.

Kernicterus Medical Information

It's safe to say that all newborns have at least a slight increase in bilirubin when they are born. This is because they are born with a lot more blood than they really need and that blood needs to be broken down so the levels are normal. The liver isn't usually mature enough to break down the bilirubin-a breakdown product of the blood cells and the bilirubin rises above normal. In some cases, the rise in bilirubin can be severe and can cause kernicterus-a condition where the brain is affected by very high levels of bilirubin.

Neonatal hyperbilirubinemia is also known as having a total serum bilirubin of 5 mg/dL or more and is extremely common. Up to 60 percent of all infants will have some degree of jaundice or yellowing of the eyes and skin within the first week of life. Most of these infants are otherwise normal and the disease is self-limiting or can be simply treated. Unfortunately, severe illnesses can be related to hyperbilirubinemia as well, such as hemolytic diseases of the newborn, metabolic problems, endocrine disorders and problems with the size or function of the liver. Infant infections can contribute to hyperbilirubinemia.

In general, normal infants rarely get bilirubin levels above 12 mg/dL and the condition is easily treatable. With risk factors for disease, the bilirubin level can get even higher and there can be more serious complications. Common risk factors include having an incompatibility between the mother's and infant's blood groups, such as Rh factor incompatibility or ABO incompatibility. Large cephalhematomas, which are blood clots on the infant head due to birth trauma, can cause elevated bilirubin levels. Bruising and other trauma to the infant during birth can increase the number of blood cells that need to be turned around to make bilirubin. Maternal valium use can be a risk factor as well as the use of pitocin during labor. Gestational diabetes and certain drugs in the infant can contribute to getting hyperbilirubinemia. Infections can make hyperbilirubinemia severe and having a sibling with the condition can mean you get neonatal hyperbilirubinemia.

Kernicterus happens when there are neurological consequences of having unconjugated bilirubin in the brain. It causes brain damage in the infant; the actual role is unknown. It happens when lipid-soluble bilirubin numbers are greater than the amount of the protein albumin, which carries the bilirubin. This means that bilirubin can cross over the blood-brain barrier, causing kernicterus. If the bilirubin is above 25 mg/dL, the risk of kernicterus is very high. Kernicterus is irreversible and can cause a condition known as chronic bilirubin encephalopathy. It results in developmental delay, motor delays, mild mental retardation and some deafness.

Early in kernicterus, there is lethargy, a high pitched cry, poor muscle tone and poor feeding behaviors. Later on, there are seizures, abnormal posture, rigid muscles, fever and eye changes.

In diagnosing neonatal jaundice, the doctor has to see the infant in a bright room. It takes a bilirubin level of about 4 mg/dL to see any kind of jaundice under the skin. The jaundice usually starts at the head and moves down toward the feet. The palms and soles are the last part of the body to become jaundiced. If it reaches the palms and the soles, the bilirubin has usually reached 15 mg/dL. Doctors also need to decide if the jaundice is just physiological or if there is a pathological reason behind having an elevated bilirubin. Doctors look for pinpoint lesions on the skin of blood, called petechiae, excessive bruising, an enlarged liver or spleen, excessive weight loss and dehydration.

Treatment of hyperbilirubinemia includes phototherapy, which is light therapy onto the infant's skin. They make chambers for light therapy and blankets that emit blue light to bring down the bilirubin. The bilirubin is broken down into water-soluble molecules that are easily excreted in the urine and the bile. Good phototherapy drops the bilirubin down about 1-2 mg/dL within four to six hours or so. Breast fed infants have a slightly harder time bringing down their bilirubin levels. Exchange transfusions where small amounts of infant blood are exchanged with healthy blood. This is the fastest way to lower bilirubin and help the infant avoid kernicterus.



The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here