What Can Doctors do to Prevent Newborn Jaundice or Hyperbilirubinemia?
Neonatal hyperbilirubinemia, commonly called jaundice, is a fairly straightforward medical condition that affects many babies. Mild cases may not require any treatment and will resolve on their own over time while more severe cases may have devastating consequences without appropriate medical intervention. In severe cases, jaundice can lead to brain damage and cerebral palsy.Tracking Bilirubin Levels
The symptoms of jaundice typically include a yellowish discoloration of the baby’s skin and whites of the eyes. Bilirubin is a yellow pigment that builds up in a baby’s bloodstream and causes this discoloration, and most mild cases will likely involve no other symptoms. Mild jaundice usually clears up without any specific treatments, but if bilirubin levels grow too high in a baby’s bloodstream the risk of severe complications increases, including some that will lead to lifelong difficulties:
- Cerebral palsy
- Dental problems
- Hearing problems
- Vision problems
- Muscle spasticity
Bowel movements can help clear a baby’s body of excess bilirubin, so a doctor may recommend increasing a baby’s feedings to encourage more bowel movements. Some other risk factors may also indicate a need for additional jaundice treatment, such as:
- Babies born premature before 37 weeks with a birth weight less than 3.5 pounds
- High bilirubin levels during the final check before discharge from the hospital
- Any jaundice development in the first 24 hours after birth
- Difficulties with breastfeeding
- Bleeding or bruising on the scalp following a difficult labor and delivery
- Genetic markers, such as a parent or blood sibling requiring phototherapy (light therapy) after birth
Treatments for early jaundice generally include phototherapy and exchange transfusions for babies who do not respond to phototherapy. During a phototherapy session, a baby wears only glasses for eye protection and a diaper and rests under white or blue “bili-lights” that help the baby’s body transform the excess bilirubin pigment in his or her bloodstream into a form that he or she can excrete through urination.
If a baby does not respond to phototherapy, he or she may require an exchange transfusion, during which the attending physician will drain the baby’s blood full of excess bilirubin and replace it with healthy donor blood.
Less severe cases of jaundice may only show symptoms for two to three weeks before clearing entirely and will require little to no special treatment. However, doctors must be able to recognize a severe case of jaundice and take appropriate action to prevent cerebral palsy and other serious medical conditions that hyperbilirubinemia can cause.Failure to Prevent Harm From Jaundice
When a doctor or midwife fails to recognize a severe case of jaundice in a newborn or does not take appropriate action to treat a severe case of jaundice, the baby may suffer from severe lifelong complications due to brain damage and cerebral palsy. A baby who suffers any type of brain damage during labor or delivery will likely experience developmental delays, cognitive impairment, and a host of other possible symptoms that may be temporary or permanent. When cerebral palsy develops, it is an incurable condition that will not get better with time, so the resulting symptoms will be permanent.
Just like any other medical condition, there is a standard of care to which attending physicians must refer when treating hyperbilirubinemia in newborns. Failure to meet this standard of care and causing harm to a baby, such as contributing to the development of cerebral palsy, would constitute medical malpractice.
Parents of a baby who developed cerebral palsy due to unchecked hyperbilirubinemia should consult with a medical malpractice attorney to discuss their options for legal recourse. The attorney can conduct a thorough examination of the baby’s medical charts to determine whether the attending doctor met the appropriate standard of care for the baby’s condition or caused the baby’s damages through medical negligence.