Skip to main navigation Skip to main content Skip to footer For Medicare For Providers For Brokers For Employers Español For Individuals & Families: For Individuals & Families Medical Dental Other Supplemental Explore coverage through work How to Buy Health Insurance Types of Dental Insurance Open Enrollment vs. Special Enrollment See all topics Shop for Medicare plans Member Guide Find a Doctor Log in to myCigna
Home Knowledge Center Wellness Library Kernicterus

Kernicterus

Condition Basics

What is kernicterus?

Kernicterus is a very rare type of brain damage that occurs in a newborn with severe jaundice. It happens when a substance in the blood, called bilirubin, builds up to very high levels and spreads into the brain tissues. This causes permanent brain damage.

Kernicterus may be prevented by treating jaundice early before it gets severe.

What causes it?

Kernicterus is caused by a high level of bilirubin in a baby's blood. If left untreated, the bilirubin can then spread into the brain, where it causes long-term damage.

A low-level buildup of bilirubin is normal. This is called mild jaundice, and it gives a newborn a slightly yellowish tint to the skin and sometimes the eyes.

Normally, extra bilirubin is removed from the bloodstream by the liver and kidneys, and it leaves the body in urine and stool. During pregnancy, the mother's body removes the extra bilirubin for the baby. After birth, it takes a few days for the newborn's liver to get good at removing bilirubin from the blood. If you feed your baby every 2 to 3 hours, mild jaundice will usually go away on its own after a few days. But if your baby has any signs of jaundice, you and your doctor will need to watch him or her closely.

If jaundice continues to get worse and is not treated, bilirubin in the blood can build up to a high level. This is when kernicterus becomes a concern. It may be that some babies have health problems that make them more likely to have bilirubin levels that climb to high levels. For example, hemolytic disease, in which a mother's Rh blood factor is not compatible with her baby's, can make a baby produce more bilirubin than normal. Intestinal blockages can make it harder for a baby to remove bilirubin.

What are the symptoms?

Kernicterus has likely already started if a baby has certain symptoms, including:

  • Extreme sleepiness and lethargy. This means a baby is difficult to wake up from sleep or can't be kept awake. But keep in mind that newborn babies sleep a lot. Lethargy in a newborn is easy to confuse with normal newborn behavior. A lethargic baby does not eat well, does not respond to touching or does not startle from sudden movements, and never seems to fully wake up.
  • A very high-pitched cry that does not sound normal.
  • Poor muscle tone. The baby may seem "floppy" and weak. Sometimes this is followed by periods when the baby's muscles flex in a way that is not normal. The baby may be stiff and arch his or her back and head.
  • A fever that occurs along with any of these other symptoms.

The lifelong damage from kernicterus may cause long-term:

  • Movement problems. A baby may develop slow and uncontrolled movements or random, jerky movements.
  • Hearing loss or deafness. Some babies may seem to have normal hearing, but they develop a problem processing sounds. This is called auditory neuropathy or auditory dyssynchrony.
  • Learning problems and other developmental disabilities.
  • Problems moving the eyes, especially looking upward.

Kernicterus may cause stains on the outside (enamel) of a child's baby teeth (primary teeth).

How is it diagnosed?

Your doctor diagnoses kernicterus through a physical exam and knowledge of your child's history of symptoms. Blood tests to measure your baby's bilirubin levels are also done. Once a baby has kernicterus, brain damage has already occurred. For this reason, it is important to follow and treat jaundice before bilirubin levels get too high.

How is kernicterus treated?

Quick treatment may help prevent further brain damage. Treatment may start with light therapy and fluids given through a needle into a vein (intravenous fluid replacement). Sometimes a baby may also have a tube placed down his or her throat or into the stomach for feeding with a special type of formula. A baby will also have a blood type test so that he or she can quickly get a blood transfusion if it is needed. A blood transfusion may be given to help remove extra bilirubin from the baby's blood.

Long-term treatment for brain damage will depend on a child's specific problems. Typical treatment includes physical therapy, speech therapy, and special education.

How can you prevent it?

You may be able to help prevent kernicterus by being aware of the symptoms of jaundice and making sure your baby gets testing and treatment when needed.

  • If your baby is still in the hospital and has signs of jaundice, your doctor or nurse may do a transcutaneous bilirubin test. A small device will be gently placed against your baby's skin to check the bilirubin level. A blood test can also check your baby's bilirubin level. A baby with a bilirubin level that requires treatment will have light therapy (phototherapy). This is usually given in the hospital. In very mild cases, you may treat your baby at home using lights the doctor gives you. Do not be alarmed if your baby has to have phototherapy. It does not mean that your baby is in danger of having brain damage. Doctors use this therapy to help prevent bilirubin from getting to a dangerous level.
  • Feed your baby at least every 2 to 3 hours during the first week or two. This helps keep bilirubin moving out of the body through urine and stool.
  • Set up a well-baby check-up before you leave the hospital. Jaundice is usually at its worst around day 5, so have the visit within the first 5 days after your child's birth. The doctor will check your baby for jaundice that is of any concern.
  • Call your doctor if you think that your baby's skin on the tummy, arms, or legs is getting yellow or that yellowing on the face is getting worse. Also look for yellowing in the whites of your baby's eyes. Get medical help right away if your baby is jaundiced and is hard to wake, acts very fussy, or is not feeding well.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

© 1995-2022 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Related Links

Jaundice in Newborns (Hyperbilirubinemia) Growth and Development, Newborn Support Groups and Social Support

<cipublic-spinner variant="large"><span>Loading…</span></cipublic-spinner>

Page Footer

I want to...

Get an ID card File a claim View my claims and EOBs Check coverage under my plan See prescription drug list Find an in-network doctor, dentist, or facility Find a form Find 1095-B tax form information View the Cigna Glossary Contact Cigna

Audiences

Individuals and Families Medicare Employers Brokers Providers

Secure Member Sites

myCigna member portal Health Care Provider portal Cigna for Employers Client Resource Portal Cigna for Brokers

Cigna Company Information

About Cigna Company Profile Careers Newsroom Investors Suppliers Third Party Administrators International Evernorth

 Cigna. All rights reserved.

Privacy Legal Product Disclosures Cigna Company Names Customer Rights Accessibility Non-Discrimination Notice [PDF] Language Assistance [PDF] Report Fraud Sitemap

Disclaimer

Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities  that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna.

All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.

Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. Cigna may not control the content or links of non-Cigna websites. Details