Kernicterus Overview: Symptoms, Causes, and Treatment
Know about kernicterus, what it is, symptoms, causes, treatment and diagnosis. Learn about the prevention and when to see the doctor.
Written by Dr. J T Hema Pratima
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 21st Aug, 2025
Introduction
Welcoming a newborn into the world is a joyous experience, but it also comes with responsibilities, especially when it comes to your baby’s health. One rare but serious condition parents should be aware of is kernicterus. While it is uncommon, understanding its symptoms, causes, and treatment can help prevent long-term complications.
This article will guide you through everything you need to know about kernicterus in simple, easy-to-understand terms.
What Is Kernicterus?
Kernicterus is a severe type of brain damage caused by extremely high levels of bilirubin (a yellow pigment produced when red blood cells break down) in a newborn’s blood. When bilirubin levels rise too much, it can cross into the brain and cause permanent damage.
This condition is preventable with proper monitoring and treatment of jaundice (yellowing of the skin and eyes) in newborns.
Consult Paediatrician for Personalised Advice
Symptoms of Kernicterus
Early detection is crucial in preventing kernicterus. Here are the key symptoms to watch for:
- Early Signs (Due to Severe Jaundice)
- Yellow skin and eyes (jaundice) that spreads to arms, legs, and belly
- Poor feeding or difficulty breastfeeding
- Extreme sleepiness (baby is hard to wake up)
- High-pitched crying
- Weak muscle tone (floppy baby syndrome)
Advanced Symptoms (If Untreated)
It includes:
- Uncontrolled muscle movements (spasticity)
- Arched back and neck (opisthotonos)
- Hearing loss or deafness
- Vision problems
- Intellectual disabilities
- Seizures
If you notice these signs, seek medical help immediately.
What Causes Kernicterus?
Kernicterus occurs when bilirubin builds up to dangerous levels in a newborn’s blood. Some common causes include:
1. Severe Jaundice
Some babies develop high bilirubin levels due to:
- Premature birth (liver is not fully developed)
- Blood group incompatibility (e.g., Rh or ABO incompatibility)
- Infections
- Bruising during birth (more red blood cells break down)
2. Delayed Treatment
- If jaundice is not treated early, bilirubin can reach the brain.
3. Certain Medical Conditions
- G6PD deficiency (a genetic disorder affecting red blood cells)
- Crigler-Najjar syndrome (a rare liver disorder)
How Is Kernicterus Diagnosed?
Doctors diagnose kernicterus through:
- Physical examination (checking for jaundice and neurological symptoms)
- Blood tests (measuring bilirubin levels)
- Hearing tests (as hearing loss is a common complication)
- Brain imaging (MRI) in severe cases
If your baby has jaundice, doctors will monitor bilirubin levels closely to prevent kernicterus.
Treatment for Kernicterus
The best approach is early treatment of jaundice before it progresses to kernicterus. Treatment options include:
1. Phototherapy (Light Therapy)
- A special blue light helps break down bilirubin in the baby’s skin.
- The baby is placed under the light with protective eye coverings.
2. Exchange Transfusion
- If bilirubin levels are extremely high, a blood transfusion may be needed to replace the baby’s blood with fresh donor blood.
3. Intravenous Immunoglobulin (IVIG)
- Used in cases of blood group incompatibility to reduce antibody attacks on red blood cells.
4. Supportive Care for Brain Damage
If kernicterus has already occurred, treatments focus on managing symptoms:
- Physical therapy for muscle stiffness
- Hearing aids for hearing loss
- Speech and occupational therapy for developmental delays
How to Prevent Kernicterus?
Prevention is key. Here’s what parents can do:
1. Monitor for Jaundice
- Check your baby’s skin and eyes daily in natural light.
- Press gently on the forehead—if the skin looks yellow when released, consult a doctor.
2. Feed Frequently
- Breastfeed every 2–3 hours to help flush out bilirubin.
- If breastfeeding is difficult, consult a lactation specialist.
3. Follow Doctor’s Advice
- If your baby is at high risk (premature or blood type incompatibility), follow bilirubin testing schedules.
4. Seek Immediate Help for Warning Signs
If your baby is extremely sleepy, refuses to feed, or has a high-pitched cry, get medical help right away.
When to See a Doctor?
Call your paediatrician immediately if your newborn:
- Has deep yellow/orange skin or eyes
- It is difficult to wake up
- Isn’t feeding well
- Has a high-pitched cry
Early treatment can prevent kernicterus and its lifelong effects.
Final Thoughts
Kernicterus is rare but serious. The good news is that it can be prevented with proper jaundice management. As a parent, staying alert to symptoms and seeking timely medical care can protect your baby’s health.
Consult Paediatrician for Personalised Advice
Consult Paediatrician for Personalised Advice
Dr. Saheli Dasgupta
Paediatrician
10 Years • MBBS, MD (Paediatrics), Indian Diploma of Paediatric Critical Care Medicine
Kolkata
Sristi Polyclinic, Kolkata
Dr. Guruprasad N
Paediatrician
7 Years • MBBS, MD Peadiatrics, DNB pediatrics
Bangalore
Apollo Clinic Bellandur, Bangalore
Dr. Sushil Kumar
Paediatrician
30 Years • MBBS, MD - Pediatrics
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(25+ Patients)
Dr. Bhukya Pavan Kalyan
General Physician
5 Years • MBBS DNB Paediatrics
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Sharvari Kulkarni
Paediatrician
5 Years • MBBS, MD PEDIATRICS
Pune
Apollo Clinic, Viman Nagar, Pune
Consult Paediatrician for Personalised Advice
Dr. Saheli Dasgupta
Paediatrician
10 Years • MBBS, MD (Paediatrics), Indian Diploma of Paediatric Critical Care Medicine
Kolkata
Sristi Polyclinic, Kolkata
Dr. Guruprasad N
Paediatrician
7 Years • MBBS, MD Peadiatrics, DNB pediatrics
Bangalore
Apollo Clinic Bellandur, Bangalore
Dr. Sushil Kumar
Paediatrician
30 Years • MBBS, MD - Pediatrics
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(25+ Patients)
Dr. Bhukya Pavan Kalyan
General Physician
5 Years • MBBS DNB Paediatrics
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Sharvari Kulkarni
Paediatrician
5 Years • MBBS, MD PEDIATRICS
Pune
Apollo Clinic, Viman Nagar, Pune
