Complications of Jaundice in Newborn Babies

Kernicterus is a rare but serious complication of untreated jaundice in babies caused by excess bilirubin damaging the brain or central nervous system.

In newborn babies with very high levels of bilirubin in the blood (hyperbilirubinaemia), the bilirubin can cross the thin layer of tissue that separates the brain and the blood (the blood-brain barrier).


The bilirubin can damage the brain and spinal cord which can be life threatening. Brain damage caused by high levels of bilirubin is also called bilirubin encephalopathy.

Your baby may be at risk of developing kernicterus if:

  • they have a very high level of bilirubin in their blood
  • the level of bilirubin in their blood is rising rapidly
  • they do not receive any treatment

Kernicterus is now extremely rare in England affecting less than 1 in a 100,000 babies.

Initial symptoms of kernicterus in babies include:

  • decreased awareness in the world around them – for example they may not make any reaction when you clap your hands in front of their face
  • their muscles become unusually floppy like a rag doll – this is known as hypotonia
  • poor feeding

As kernicterus progresses additional symptoms can include:

  • seizures (fits)
  • they begin arching their neck or their spine back, or in some cases, both

Treatment for kernicterus involves using an exchange transfusion as used in the treatment of newborn jaundice.

Although if significant brain damage has occurred a child can often develop long-term symptoms that will persist throughout their lifetime, such as:

  • cerebral palsy (a condition that affects the brain and nervous system) that causes both increased and decreased muscle tone, and affects your baby’s movement and coordination
  • hearing loss – which can range from mild to severe
  • learning difficulties – though this tends to be only mild to moderate
  • involuntary twitching of different parts of their body
  • problems maintaining normal eye movements; people affected by kernicterus have a tendency to gaze upwards or from side to side rather than straight ahead
  • the normal development of the teeth can be disrupted resulting in teeth that are misshapen, discoloured and vulnerable to tooth decay 


NHS Choices
Complications of jaundice in newborn babies
Last reviewed: 06/02/2012

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