Kernicterus Causes

Fact-Checked and Medically Reviewed by:
Katie Lavender, RN Registered Nurse
Quick Answer

Also known as bilirubin encephalopathy, kernicterus is a brain disorder that can occur in infants with severe jaundice that was left untreated. It is linked to high bilirubin levels, a yellowish chemical made when the body breaks down old red blood cells. Kernicterus can cause serious harm to newborns, including hearing loss, brain damage, or cerebral palsy.

Get a Free Case Review

What Are Common Kernicterus Causes?

A mother holds her newborn babyKernicterus occurs when bilirubin builds to extremely high levels and spreads into the brain tissue and central nervous system. Bilirubin is a chemical made by the body when old red blood cells are broken down.

Newborn jaundice is usually what causes kernicterus. Babies with jaundice have yellowish-looking skin, eyes, and mucus membranes. The yellow coloring comes from the bilirubin.

Jaundice is a common and treatable condition. However, if left untreated, it can become so severe that it leads to kernicterus, which can cause permanent brain damage.

“No baby should develop brain damage from untreated jaundice.”

—Centers for Disease Control and Prevention (CDC)

Is Jaundice the Only Cause of Kernicterus?

No. Although jaundice is one of the leading kernicterus causes, other conditions can trigger the condition.

Causes of kernicterus include:
  • Biliary system problems: These can affect the ducts and organs that make and store bile, including outside and inside of the liver and gallbladder.
  • Breastfeeding jaundice: This occurs when a baby isn’t getting enough milk, leading to higher bilirubin levels because they aren’t having enough bowel movements to remove it.
  • Breast milk jaundice: Often in the second week of life or later, this is believed to result from substances in the mother’s milk that hinder the baby’s liver from processing bilirubin.
  • Crigler-Najjar syndrome: This is one of the top causes of newborn jaundice. It is a rare and severe disorder that creates toxic bilirubin levels in the blood.
  • Gilbert syndrome: This is a common condition in which the liver doesn’t process bilirubin properly.
  • Hypoalbuminemia: Occurs when the body does not produce enough albumin (a protein in blood plasma made by the liver.)
  • Medical negligence: Undiagnosed or untreated jaundice in newborns resulting from a medical error is sadly one of the kernicterus causes.

Risk Factors for Kernicterus

The leading kernicterus cause is known to be high levels of bilirubin. Additionally, certain risk factors are linked with kernicterus but do not necessarily cause it.

Here are some of the main risk factors for kernicterus.

Bruising During Birth

Newborn infants with bruises at birth are more likely to develop jaundice and kernicterus. Bruises can be a result of birth trauma, which occurs when organs or tissues are damaged during the birthing process. When large bruises heal, the body may release high bilirubin levels, leading to jaundice.

Dark Skin Coloring

Doctors may miss jaundice in babies with darker skin colors. They can check the inner lips and gums to check for yellowing. If doctors have any suspicion of jaundice, they should perform a bilirubin test immediately. All newborns should go through bilirubin testing periodically for the first 24-48 hours after delivery.

Different Blood Types Between Mother & Newborn

Mothers with an O blood type or Rh-negative factors may have babies with higher bilirubin levels. Their babies are more at risk for having antibodies that act against red blood cells, a term called “Coombs positive.”

Doctors should give a medication called RhoGAM® to mothers with Rh factors to prevent Rh incompatibility from developing during pregnancy (it protects the mother’s antibodies from rejecting and attacking the baby’s blood cells during pregnancy). If blood cells are attacked, excess bilirubin releases into the infant’s bloodstream.

East Asian Ethnicity

Babies born to families of East Asian descent are more likely to develop jaundice, one of the main kernicterus causes.

Failure to Diagnose or Treat Jaundice

Babies are more likely to develop kernicterus if doctors fail to diagnose or treat jaundice promptly. In this situation, birth injury medical negligence could be at play.

Normal pink skin of a healthy baby compared to the yellow skin of a baby with severe jaundice

Jaundice Family History

Babies with siblings who had jaundice are more likely to develop jaundice and kernicterus. This is because some families inherit jaundice-causing conditions, such as low levels of G6PD.

This enzyme helps prevent blood cell damage, which reduces the risk of excess bilirubin being released into the bloodstream.

Premature Births

Preterm babies born before 8.5 months or 37 weeks are more likely to have jaundice and kernicterus because their livers are not fully developed. Less developed livers may not be able to regulate high levels of bilirubin.

Trouble Feeding After Birth

Newborn babies with feeding problems may not be able to remove waste from their bodies effectively. Bilirubin is removed from the body via stool. This, in turn, can lead to a buildup of bilirubin in the blood, leading to jaundice and, eventually, kernicterus.

If you have questions about kernicterus causes, connect with one of our labor and delivery registered nurses.

Nurse Beth Carter

Talk to A Nurse Now

Call or chat with a caring, experienced nurse right now — we’re standing by to get you help and answers.

Newborn Kernicterus Treatment

If you believe your newborn has kernicterus, get medical help right away. Kernicterus is a serious condition and should be treated without delay.

If the condition is suspected, the medical team will observe your infant for kernicterus symptoms.

Symptoms of kernicterus include:
  • Arched body like a bow (the body is bent forward, and the head or heels or neck are bent backward)
  • Extreme sluggishness and sleepiness
  • Fever that occurs with other symptoms
  • High-pitched cry that does not sound normal
  • Poor muscle tone or hypotonia (an overly floppy body)
  • Seizures and muscle spasms
  • Unusual eye movements

Next, the care team will perform a jaundice bilirubin test by placing a light meter on the baby’s head. If the bilirubin level is high, the team will order a blood test.

If the blood test bilirubin level is high, the team will treat your baby by putting them under special lights. This type of light therapy is called phototherapy and will not hurt your baby. The team will also increase the baby’s milk intake.

Doctors will perform a blood exchange transfusion if the baby has very high bilirubin levels.

Can Kernicterus Cause Brain Damage?

Yes. Kernicterus can cause long-term brain damage. Fortunately, doctors almost always diagnose kernicterus before bilirubin levels become high enough to cause serious brain injury.

Brain damage from kernicterus can cause the following problems:
  • Deafness or hearing loss
  • Developmental disabilities and learning problems
  • Movement disorders, such as cerebral palsy
  • Problems moving the eyes, especially looking up

In some cases, brain damage caused by kernicterus can tragically result in death.

Legal Options for Newborn Kernicterus Caused by Medical Negligence

If your baby developed kernicterus due to the medical team’s failure to diagnose or treat jaundice, you might have legal options. Depending on the details of your case, you may be eligible to file a birth injury lawsuit against your baby’s health care team.

If you win, you may receive financial compensation from a kernicterus settlement for your baby’s treatment, medical expenses, medications, pain and suffering, and more.

Our partner law firm has helped recover over $962 million for birth injuries across the country.

You may also be able to receive compensation for lifelong disabilities and medical necessities if your child developed cerebral palsy, deafness, hearing loss, movement problems, or developmental disabilities due to medical negligence.

Get a Free Case Review

A free case review is the first step in pursuing compensation for you and your family.

Get a Free Case Review

Seek Help With a Newborn Kernicterus Medical Negligence Claim

Discovering that your newborn has kernicterus can be traumatic, especially if they experience potentially life-threatening or severe complications.

Connect with us today to learn how we may be able to help. We can answer your questions about kernicterus causes and connect you with a top birth injury lawyer if you are eligible.

Get started with a free case review today.

Kernicterus Causes FAQs

What is kernicterus caused by?

Kernicterus is caused by a buildup of bilirubin, a chemical created by the body when old red blood cells break down. One of the main symptoms of bilirubin buildup is jaundice, or the yellowing of the skin, whites of the eyes, and mucus membranes. Other causes of kernicterus include Crigler-Najjar syndrome, Gilbert syndrome, and biliary system problems.

How common is kernicterus in newborn children?

According to the Centers for Disease Control and Prevention (CDC), about 60% of all babies develop jaundice. However, it is rare for jaundice to turn into kernicterus. The dangerous kernicterus bilirubin level is almost always avoidable because jaundice is usually treated before it becomes a problem.

How do I know if my baby has kernicterus?

Babies with kernicterus have orange or yellowish skin, extreme fatigue, and high-pitched cries. They may also be floppy and have difficulties feeding.

If you suspect your baby has kernicterus, seek emergency medical help right away. A medical team will be able to determine what is causing your baby’s symptoms.

Can a baby recover from kernicterus?

Yes, babies can recover from kernicterus if they receive treatment on time. However, if they don’t receive treatment on time, they may develop permanent brain damage, which can cause deafness or cerebral palsy.

What are the signs of kernicterus?

Babies with kernicterus are likely to have orangish or yellowish skin, extreme fatigue, fussiness, and lower-than-average diaper changes. They may also have poor muscle tone and unusual eye movements. Fever is likely to occur with any of these symptoms.

How common is kernicterus in newborns?

Kernicterus is considered extremely rare. According to a 2019 Swedish study, only 1.3 out of 100,000 infants develop kernicterus.

Can a doctor’s error cause kernicterus?

Yes, if a doctor fails to diagnose and treat neonatal jaundice in time, your baby may develop kernicterus.

Birth Injury Support Team
Reviewed by:Katie Lavender, RN

Registered Nurse

  • Fact-Checked
  • Editor

Katie Lavender has over 8 years of experience as a Registered Nurse in postpartum mother/baby care. With hands-on experience in Labor and Delivery and a role as a Community Educator for newborn care, Katie is a staunch advocate for patient rights and education. As a Medical Reviewer, she is committed to ensuring accurate and trustworthy patient information.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
  1. Centers for Disease Control and Prevention. (2020, December 8). What are jaundice and kernicterus? Retrieved June 30, 2024, from https://www.cdc.gov/ncbddd/jaundice/facts.html
  2. Cleveland Clinic. (2022, March 18). Hypoalbuminemia. Retrieved June 30, 2024, from https://my.clevelandclinic.org/health/diseases/22529-hypoalbuminemia
  3. JAMA Network Open. (2019, March 22). Rates of extreme neonatal hyperbilirubinemia and kernicterus in children and adherence to national guidelines for screening, diagnosis, and treatment in Sweden. Retrieved June 30, 2024, from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2728619
  4. Mayo Clinic. (2022, July 1). Gilbert syndrome. Retrieved June 30, 2024, from https://www.mayoclinic.org/diseases-conditions/gilberts-syndrome/symptoms-causes/syc-20372811
  5. Mayo Foundation for Medical Education and Research. (2022, October 8). Bilirubin test. Mayo Clinic. Retrieved June 30, 2024, from https://www.mayoclinic.org/tests-procedures/bilirubin/about/pac-20393041
  6. Mount Sinai. (n.d.). Bilirubin encephalopathy. Retrieved June 30, 2024, from https://www.mountsinai.org/health-library/diseases-conditions/bilirubin-encephalopathy
  7. Mount Sinai. (n.d.). Jaundice. Retrieved June 30, 2024, from https://www.mountsinai.org/health-library/diseases-conditions/jaundice
  8. MyHealth Alberta. (2021, December 13). Kernicterus. Retrieved June 30, 2024, from https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=ue5852
  9. National Cancer Institute. (n.d.). Biliary system. Retrieved June 30, 2024, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/biliary-system
  10. National Library of Medicine: National Center for Biotechnology Information. (2023, January). Crigler Najjar syndrome. StatPearls. Retrieved June 30, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK562171/
  11. National Library of Medicine: National Center for Biotechnology Information. (2023, January). Kernicterus. StatPearls. Retrieved June 30, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK559120/
  12. National Organization for Rare Disorders (NORD). (2008, February 5). Kernicterus. Retrieved June 30, 2024, from https://rarediseases.org/rare-diseases/kernicterus/
  13. NHS. (2022, February 3). Kernicterus. Retrieved June 30, 2024, from https://www.nhs.uk/conditions/jaundice-newborn/complications/