The mild, common form of jaundice that appears in the first few days of life as a newborn’s liver matures. It typically resolves on its own within one to two weeks and causes no lasting harm.
Understanding Jaundice and Its Effect on Newborns
Navigating a newborn’s medical diagnosis can be stressful for any parent, especially when a common condition leads to unexpected complications. This guide is designed to help families understand newborn jaundice, recognize the risks of untreated hyperbilirubinemia, and explore their options if medical errors affect their child’s health.
What is jaundice?
Jaundice is the yellowing of a newborn’s skin and eyes caused by a buildup of bilirubin, a pigment produced when the body breaks down old red blood cells. A newborn’s liver is still maturing in the days after birth, and it doesn’t always clear bilirubin from the bloodstream as efficiently as an older child’s or adult’s liver does.
In most infants, bilirubin levels rise slightly, cause mild jaundice, and fall again within one to two weeks as the liver catches up. On its own, jaundice is an extremely common and usually harmless part of a newborn’s first days. Concern arises when bilirubin levels climb too high, rise too quickly, or go unmonitored, because in rare cases this can progress to kernicterus, a preventable form of brain injury caused by bilirubin crossing into brain tissue.
Signs and symptoms of jaundice
Recognizing jaundice early gives medical teams the chance to intervene before bilirubin levels become dangerous. Signs that parents and care teams should watch for include:
- A yellowish tint to the skin, often starting on the face and spreading to the chest, abdomen, and legs
- Yellowing of the whites of the eyes
- Excessive sleepiness or difficulty waking for feedings
- Poor feeding or a weak suck
- A high-pitched or unusual cry
- Extreme fussiness or irritability
- Arching of the back or neck
- Unusual muscle stiffness, or alternatively, unusual limpness
- In advanced cases, seizures
What causes jaundice?
Several factors can contribute to newborn jaundice, and some babies face a higher risk of dangerously elevated bilirubin than others. Common causes and risk factors include:
- Physiologic jaundice, related to the natural immaturity of a newborn’s liver
- Premature birth, since a preterm baby’s liver is even less developed
- Blood type incompatibility between mother and baby (Rh or ABO incompatibility), which can cause red blood cells to break down more quickly
- Breastfeeding or breastmilk jaundice, often linked to feeding difficulties in the first days of life
- G6PD deficiency and other inherited conditions affecting red blood cell breakdown
- Bruising from a difficult delivery, which adds extra bilirubin as the bruise resolves
- Infection or other underlying medical conditions
When jaundice may be a sign of medical malpractice
Jaundice itself is common, and in most cases its presence alone is not a sign that anything went wrong. Malpractice claims involving jaundice are not based on the fact that a baby developed it, but on whether the medical team recognized and responded to it appropriately. The following scenarios may point to negligence:
- Failing to check bilirubin levels before hospital discharge, particularly for babies discharged within 24 to 48 hours of birth
- Not following standard bilirubin screening or risk-assessment protocols
- Dismissing visible signs of jaundice as normal without further testing
- Delaying phototherapy or other treatment once elevated bilirubin levels are identified
- Failing to schedule or recommend timely follow-up appointments after discharge
- Not communicating warning signs to parents so they know when to seek immediate care
- Failing to recognize or respond to symptoms of acute bilirubin encephalopathy
Determining whether a jaundice case involved a medical error requires a careful review of the medical record and the standard of care that should have been followed. The attorneys at Wais, Vogelstein, Forman, Koch & Norman, LLC work closely with medical experts to evaluate these cases and help families understand whether their child’s injury could have been prevented.
Treatment and long-term outlook
Most jaundice resolves with simple monitoring or a short course of phototherapy (light therapy), which helps the body break down bilirubin more efficiently. In more severe cases, doctors may use an exchange transfusion to remove bilirubin from the blood directly. When treated promptly, the vast majority of infants recover fully with no lasting effects.
When severe jaundice is missed or undertreated and progresses to kernicterus, however, the resulting brain injury is permanent. Children affected by kernicterus may experience a form of dyskinetic cerebral palsy, hearing loss, impaired upward eye movement, and dental enamel abnormalities. Families navigating these lifelong needs may find it helpful to also review our page on cerebral palsy and the support options available.
Injury Types: Jaundice
Stages of jaundice and bilirubin brain injury.
Bilirubin’s effect on the brain tends to move through recognizable stages. Understanding them can help families make sense of what their child experienced, and know what to watch for as their child grows.
Physiologic jaundice
Acute bilirubin encephalopathy
The early, and potentially reversible, stage of brain injury that can occur when severe jaundice goes untreated. Early symptoms may include lethargy, poor feeding, and abnormal muscle tone, progressing to more serious signs if not addressed.
Pathologic (severe) jaundice
Jaundice that appears earlier, rises faster, or reaches higher bilirubin levels than expected. It often signals an underlying cause and requires closer monitoring or active treatment.
Chronic bilirubin encephalopathy (kernicterus)
The permanent stage of brain injury that can follow untreated acute bilirubin encephalopathy. It often involves lasting movement disorders, hearing loss, and vision or dental effects that require lifelong care.
Frequently Asked Questions
Common questions about jaundice.
These are some of the questions families ask most often, and we’re always glad to talk through your specific situation whenever you’re ready.
What is the difference between jaundice and kernicterus?
Jaundice is the common, often harmless yellowing of a newborn’s skin caused by elevated bilirubin. Kernicterus is a rare but serious complication that occurs when jaundice is left untreated and bilirubin levels rise high enough to cause permanent brain damage.
Is jaundice always caused by medical malpractice?
No. Jaundice is a normal part of many newborns’ first days and is not, on its own, evidence of an error. Malpractice may be involved when a medical team fails to monitor bilirubin levels appropriately, dismisses warning signs, or delays treatment that could have prevented a serious complication like kernicterus.
How is jaundice-related brain injury treated?
Jaundice is typically treated with phototherapy, and severe cases may require an exchange transfusion to lower bilirubin levels quickly. Once kernicterus has occurred, treatment shifts to long-term supportive care, including physical, occupational, and speech therapy, to help a child manage the resulting effects.
How long do I have to file a claim?
The deadline to file a birth injury claim varies depending on where you live and can also depend on factors like the child’s age at diagnosis. Because these deadlines can be strict, it’s important to speak with an attorney as soon as possible so your family doesn’t lose the opportunity to pursue a claim.
