Kernicterus Diagnosis – How Is It Accomplished

To prevent the tragedy of kernicterus, diagnosis and management of jaundice at the earliest stages of an infant’s life is critical. The American Academy of Pediatrics has issued a clinical practice guideline, recommending that all newborn nurseries have a protocol for assessing jaundice. Healthcare professionals must be aware of the warning signs of kernicterus.

Kernicterus diagnosis involves the detection of elevated levels of bilirubin in the baby’s bloodstream. At a minimum, “bili” levels should be checked every 8 to 12 hours in the first 48 hours of life and again before 5 days of age. It is done with a simple blood test.

Early Kernicterus Diagnosis

A blood test is performed which analyzes total serum bilirubin (TSB) levels. The medical staff will collect a small sample of the baby’s blood by way of a heel prick. The blood is sent to the lab and tested for bilirubin levels.

An alternative test may also be used that is less invasive (no pinprick) called transcutaneous bilirubin testing. A sensitive light meter is placed on the baby’s forehead and can determine what the level of bilirubin is in the baby’s bloodstream. If the bili levels are high, blood tests should be ordered.

To analyze the results of the blood test, the doctor uses a chart called a bilirubin nomogram to figure out if the baby is at risk of kernicterus. The chart risk is predicted in one of 4 categories: A – B – C – D (low risk, moderate risk, high risk, or very high risk.)

Accurate kernicterus diagnosis must always be based on the total serum bilirubin levels. TBS levels should be checked repeatedly, even during treatment, to make certain the levels of bilirubin are returning to normal. With routine screening and good follow-up there is no reason any baby should have to suffer a lifetime of brain injury from kernicterus.

Levels of bilirubin do not peak until at least 3 days after the baby is born. Most mothers and babies leave the hospital before then, which is why it is very important that your baby have a follow up appointment within 48 hours after discharge from the hospital, even if the baby was tested in the hospital.

Could early kernicterus diagnosis have prevented your child’s brain damage?

Because the failure to diagnose kernicterus can cause devastating injury, the law seeks to protect victims. Any incidence of brain damage caused by jaundice at birth should be investigated to see if the levels of bilirubin were detected and monitored at the time of the event.

Because kernicterus is medically preventable, any negligent diagnosis, failure to diagnose, or delayed diagnosis of kernicterus is a strong indication that medical malpractice may have occurred.

Do you believe your child may be the victim of such negligence? How do you get to the truth? What can you do to get the help you need with lifetime care costs? At Ratzan Law Group, we believe in giving a powerful voice to those who would otherwise have none. If you have questions, speak with the kernicterus attorneys at our firm today about your child’s injury.


Learn more about the effects of a missed kernicterus diagnosis.

Kernicterus MRI scans help us visualize the effects of kernicterus, and aid in the overall diagnosis.