New guidelines introduced: jaundice and kernicterus in new born babies
New guidelines from the National Institute for Health and Clinical Excellence (NICE) suggest that health workers should no longer rely on their instincts alone to judge the severity of jaundice in a newborn baby.
The health watchdog has recommended that all newborns with suspected jaundice should be given a blood test to check for this common and usually harmless condition, which can in rare cases be fatal.
Jaundice in new-borns
Jaundice is prevalent among newborns - around 80% of premature babies and 60% of full-term babies develop it within the first week of life. The condition is caused by high levels of bilirubin - a waste product created by the breakdown of red blood cells. The baby's immature liver often struggles to remove this substance from the body, so it starts to build up. Deposited in the skin and eyes, it causes the yellow colour from which jaundice gets its name, but in serious cases it can damage the brain.
Kernicterus
The risk of kernicterus, a form of brain damage, can be averted completely if serious jaundice is spotted early. Kernicterus, can cause long-term problems such as cerebral palsy and hearing loss, and in a handful of cases can be fatal. It is rare, but thought to be on the increase, affecting up to 12 babies a year in the UK.
Because for the vast majority of babies jaundice is entirely harmless, there has been some uncertainty as to when and how to treat it. However the new guidelines include specific advice on when to start and stop treatment.
Warning symptoms and signs
- Severe jaundice - particularly in the first 24 hours of life
- Impaired consciousness
- Abnormal muscle tone
- Spasms in the head, neck and spine
- Seizures
Health workers tend to rely on the appearance of the baby alone to diagnose the severity of a case of jaundice, but the National Institute for Health and Clinical Excellence (NICE) notes that this can be problematic, particularly when it comes to babies with darker skin tones.
The watchdog says all babies should be checked for jaundice regularly in the first 72 hours and, when the condition is suspected, tests to ascertain bilirubin level should be carried out every six hours.
Light therapy should then be used for babies with jaundice above a certain threshold, with treatment intensifying to include blood transfusion for the worst affected.
Commenting on the new guidelines, top ranked medical negligence solicitor Susan Brown from Reading based law firm Boyes Turner said: “We are currently dealing with a number of cases where babies have suffered brain injury in the first few days/weeks of their life. Several cases have resulted from failures by hospital staff to adequately treat jaundice. Hopefully these new guidelines, which the Chief Medical Officer called for back in 2006, will make staff more alert to the problem and lead to a reduction in the number of babies who ware injured in this way.”
Consistent with our policy when giving comment and advice on a non-specific basis, we cannot assume legal responsibility for the accuracy of any particular statement. In the case of specific problems we recommend that professional advice be sought.
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