is Kernicterus on the rise in America?

Kernicterus, a rare but devastating form of brain damage caused by severe neonatal jaundice, is making an unexpected comeback in the United States. Once considered a preventable condition, recent reports suggest an uptick in cases, raising concerns among pediatricians and public health experts.

Kernicterus occurs when excessive bilirubin—a yellow pigment produced during red blood cell breakdown—crosses the blood-brain barrier, leading to permanent neurological damage. Symptoms include:

• Severe muscle stiffness (hypertonia)

• Hearing loss

• Intellectual disabilities

• Movement disorders (dyskinetic cerebral palsy)

Several factors may be contributing to the resurgence:

1. Early Hospital Discharge

   • Newborns are often discharged within 24–48 hours, before jaundice peaks (around days 3–5).

   • Parents may miss warning signs due to lack of follow-up.

2. Breastfeeding Challenges

   • Insufficient feeding can worsen jaundice by reducing bilirubin excretion.

   • Poor lactation support may delay intervention.

3. Racial Disparities

   • Studies show Black and Asian infants have higher bilirubin levels but are sometimes under-monitored.

4. Medical Overconfidence

   • Some providers underestimate jaundice risks, relying on visual assessment rather than bilirubin testing.

5. Vaccine Hesitancy & Home Births

   • Unmonitored home births and delayed pediatric visits increase risks.

Kernicterus is 100% preventable with:

• Universal bilirubin screening before discharge

• Parental education on jaundice symptoms (yellow skin/eyes, poor feeding)

• Timely phototherapy or exchange transfusions in severe cases

**References: CDC, American Academy of Pediatrics (AAP), recent clinical studies