A PREVENTABLE BRAIN injury in newborn babies is highly unusual, says a leading pediatrics expert. But it is possible to prevent nearly all cases of kernicterus, a rare but devastating brain disorder that is caused by untreated severe jaundice, or hyperbilirubinemia.
More than half of newborns develop jaundice, a condition in which levels of bilirubin--a breakdown product of hemoglobin--rise faster than a baby's liver can excrete it. While jaundice usually goes away on its own as the baby's systems mature, in about 350,000 newborns each year it leads to hyperbilirubinemia, which requires light therapy. But left untreated, more newborns are going on to develop kernicterus, recent studies suggest.
Ann Stark, M.D., professor of pediatrics at Baylor College of Medicine in Houston and chairwoman of the American Academy of Pediatrics (AAP) group that implements hyperbilirubinemia guidelines, points to several likely reasons for the trend: shorter hospital stays for newborns, the growing practice of caring for slightly premature babies in the newborn nursery with full-term infants, and the relaxed attitude of some pediatricians in watching for and treating jaundice.
New AAP guidelines call for an assessment of the baby's risk of developing unsafe bilirubin levels before her hospital discharge, in addition to a pediatric exam at age 3 to 5 days. And because decreased fluid intake is linked to high bilirubin levels, the guidelines emphasize frequent breast-feeding--eight to 12 times a day--during the first few days to increase milk supply. At home, parents should call the pediatrician if the baby's jaundice is spreading, if the whites of her eyes are yellow, if she's difficult to arouse or if there are any breastfeeding difficulties, Stark says.
COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group
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