3 in 5 Newborns Develop Jaundice: Learn About Jaundice and Oregon Medical Malpractice
Jaundice can be a serious issue and result in a birth injury. While jaundice can happen naturally, that does not mean that Oregon medical malpractice does not increase it or result in damages. In fact, untreated jaundice can result in a debilitating and damaging condition known as kernicterus, as well as other dangerous conditions that could result in catastrophic injury. This is when jaundice and Oregon medical malpractice could be catastrophic.
Jaundice is one of the most common conditions a newborn can have in their first few days of life. About 3 in 5, or 60 percent of newborns have jaundice. Parents to a newborn may be confused when they have a newborn with jaundice, because although it is so common, it can be either easily treated or become very serious very fast. Jaundice for a newborn can disappear in three weeks of birth, or can become brain damage that leaves a child disabled for life. You cannot always rely on medical providers to spot the signs and symptoms of jaundice. However, there are standard processes and procedures on the medical provider’s part that need to be carried out if your newborn has jaundice, or is at risk of having jaundice. Contact our Oregon birth injury attorney today if you need to review what was or what was not done for your child. This is because jaundice and Oregon medical malpractice can result in serious personal injuries or the wrongful death of an innocent infant or newborn.
What is Jaundice?
Jaundice is when an infant has a yellow discoloration, both in their skin and white part of their eyes. Jaundice occurs because there is a buildup of bilirubin in the newborn’s blood. Bilirubin is the yellow pigment portion of red blood cells. There is an excess of bilirubin typically because the newborn’s liver is not mature enough to rid of it in their bloodstream. However, this is not the sole reason for the infant’s liver’s inability to rid of the bilirubin—an underlying disease may also be the cause.
Jaundice usually develops two to four days following the newborn’s birth. If a baby has been born between 35 weeks gestation and full term, treatment is typically unnecessary. Rather, the jaundice tends to go away naturally. However, if the newborn does not fall into that category, the newborn is at a higher risk of developing severe jaundice, which does require close medical attention and treatment or treatments. This is primarily due to the fact that untreated severe jaundice can lead to brain damage, which in the case of high bilirubin, would be called kernicterus.
Causes of Jaundice
As mentioned, jaundice is directly caused by excess bilirubin in the bloodstream. Why is there excess bilirubin in the bloodstream to begin with, though?
Bilirubin, the yellow pigment of a red blood cell, is a normal substance in the body’s system. Infants, however, produce more bilirubin than adults do, due to more of it being produced in the first few days of life. Moreover, at the same time, for newborns, red blood cells are being broken down faster as well. Usually, bilirubin is filtered through the liver from the bloodstream and released into the intestinal tract. Since a newborn’s liver is not mature yet, it has difficulty doing this, hence the excessive amount. Prior to birth, the infant was able to filter out the bilirubin through the mother’s liver.
Still, there are other reasons as to why a newborn has jaundice. In other words, other health conditions that are separate from the usual way it develops. The following are examples of this:
- Mother and baby’s blood types do not match—breaks red blood cells down quicker
- Internal bleeding
- Baby’s liver is not functioning properly, due to an infection or disease that affects the liver. Examples are hepatitis and cystic fibrosis.
- Baby’s red blood cells are problematic—have too many. This is more common among twins and small newborns.
- Sepsis, as this is an infection in the blood
- Bruising during labor or at birth—bruising increases bilirubin levels
- G6PD deficiency—G6PD is an enzyme and this condition makes it so that red blood cells do not work as properly
Additionally, certain types of newborns make it so that they have a higher likelihood of developing jaundice. They are as follows:
- Premature babies, or babies born before 37 weeks of being pregnant. Premature babies are less developed, therefore causing the liver to be even less mature to filter out the bilirubin
- Newborns with East Asian or Mediterranean backgrounds—studies have shown this
- Babies who are not breastfeeding well. Specifically, babies who are not getting fed when they need to.
What to Look For: Signs and Symptoms
A main way of checking your baby for jaundice is by examining his or her skin. If a baby has jaundice, they will have a yellow, orange, or green-yellow color. Often, it occurs first on the face, then spreads to other areas of the body and whites of the eyes. It is strongly recommended to examine the baby for jaundice in good lighting, such as during the day or under fluorescent lights. It should be noted that newborns with darker skin will not appear as yellow sometimes.
Additionally, if the baby is difficult to wake up or does not sleep at all, that can be an indicator. Newborns that have trouble breastfeeding or sucking from a bottle is another. Fussiness can also be a sign. Finally, if the newborn has too few wet or dirty diapers, that can be one sign of jaundice.
It is much more serious, and likely that the newborn has dangerously high levels of bilirubin if you find the following:
- Body is stiff, limp, or floppy
- Strange eye movements are being made
- Arches backwards
- Cries and will not stop or has a very high-pitched cry
- Any other signs or symptoms that concern you
- Not gaining weight
- Was poorly fed or is poorly feeding
If a newborn with severe jaundice is not quickly and effectively treated, they are at risk to develop kernicterus, or brain damage from untreated severe jaundice. If the kernicterus is left untreated, or not properly treated, an infant can develop the following:
- Athetoid cerebral palsy, or uncontrollable body movements
- Hearing loss
- Dental issues
- Intellectual disabilities
- Vision complications
How is Jaundice Diagnosed?
Jaundice is diagnosed either through a blood test, physical exam, or skin test. Upon birth and at departure from the hospital, newborns are supposed to be tested and examined for jaundice, whether mild or severe. The blood test will be able to determine if there are excessively high levels of bilirubin in the newborn’s system. A physical exam allows the doctor to check the newborn’s skin for signs and symptoms of jaundice, such as yellowish skin. Finally, the skin test is useful, in that a device, called a bilirubinometer, is used to identify the bilirubin level by placing it against the newborn’s forehead. A bilirubinometer determines the levels from measurements given from the reflection of a special light that shines through the skin. Ensure that the proper steps were taken by medical staff to determine that your newborn has or does not have jaundice, by contacting our Oregon birth injury attorney today.
How to Properly Treat Jaundice, and if Needed, Kernicterus
There is a long list of what medical professionals need to do to properly and effectively treat a newborn with jaundice. If your newborn has been diagnosed with mild jaundice, he or she may likely not need treatment. Your medical provider may simply direct you to feed your baby sufficiently, as poor feeding can lead to jaundice. In well-fed newborns, jaundice should clear up in about two to three weeks.
With severe jaundice, on the other hand, more serious treatments are required immediately. They are as follows:
- Phototherapy—special lights are used to be shone on the baby to aid in getting the excess bilirubin out of their system, via urination and defecation. As such, the newborn wears diapers and special sunglasses and is placed on a blanket. Phototherapy can be done at the hospital or at home. A light blanket may be used as well.
- Exchange transfusion—a particular type of blood transfusion from a donor. Exchange transfusion is typically performed if phototherapy does not work. This rids the body of the excess bilirubin by replacing the blood with small doses of the donor’s blood, to cancel out the mother’s mismatched blood. This is typically a last resort level option.
- Intravenous immunoglobulin, or IVIg—this is if the mother and baby’s blood types do not match. In this case, IVIg would be done to provide the newborn with a blood protein through a vein to reduce antibodies.
Treatments for Kernicterus
If jaundice has regrettably already turned into kernicterus, different treatments must be utilized, as kernicterus is very serious. Treatment for kernicterus, like severe jaundice, works to reduce the bilirubin in the bloodstream. Again, like severe jaundice, exchange blood transfusions are performed, to repeatedly replace the newborn’s blood with small amounts of the donor’s blood, until most of the blood is exchanged.
Another procedure used for kernicterus is plasmapheresis. Plasmapheresis removes toxic substances, such as plasma parts, toxins, and metabolic substances from the bloodstream. Here, the newborn’s blood is withdrawn and the plasma is separated from the blood cells. Then, the newborn’s plasma is replaced with another human’s plasma. Finally, the new blood and plasma combination is infused back into the newborn.
Phototherapy is used, as it is for severe jaundice as well. A fluorescent light is placed on the newborn’s bare skin and the eyes are covered with goggle-like shields. Here, the light speeds up the excretion of the excessive bilirubin, through urination and defecation.
Importantly, these treatments are suggested to be applied to the newborn as soon as possible, as some of them become less effective as a person ages. For example, phototherapy becomes less effective if the individual is not young enough, as the skin thickens and body mass increases. If that is the case, liver transplantations are sometimes performed in an effort to prevent brain damage associated with kernicterus.
Call Our Portland Birth Injury Lawyer for Jaundice and Medical Malpractice Issues in Oregon
If you or a loved one have been seriously injured or killed as a result of medical malpractice contact the Oregon Medical Malpractice Lawyers at Kuhlman Law at our number below or fill out the intake form. We offer a free initial case evaluation and handle cases on a contingency fee which means that you pay no money unless we recover.
Our law firm handles cases throughout the state including Bend and Portland Oregon, Redmond, Central Oregon, Sisters, Madras, Multnomah County, Deschutes County, Salem, Eugene, Corvallis, Lane County, Medford, Gresham, La Grande, Albany, Medford, Beaverton, Umatilla, Pendleton, Cottage Grove, Florence, Oregon City, Springfield, Keizer, Grants Pass, McMinnville, Tualatin, West Linn, Forest Grove, Wilsonville, Newberg, Roseburg, Lake Oswego, Klamath Falls, Happy Valley, Tigard, Ashland, Milwakie, Coos Bay, The Dalles, St. Helens, Sherwood, Central Point, Canby, Troutdale, Hermiston, Silverton, Hood River, Newport, Prineville, Astoria, Tillamook, Lincoln City, Hillsboro, and Vancouver, Washington.
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