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Hyperbilirubinemia

mother and child incubatorHyperbilirubinemia is a condition that causes jaundice. Though easily treated with early detection, it has been linked to serious health conditions including brain damage in infants who do not receive treatment. A family whose child has been injured by untreated jaundice may be eligible to recover compensation from the doctor or hospital responsible by filing a medical malpractice lawsuit.

Eisbrouch Marsh’s team of birth injury lawyers has witnessed firsthand, the unbelievable nature of this injury and the devastating impact the diagnosis has on a family who believed they delivered a healthy baby. We believe that failure to recognize the symptoms of this common condition is clearly negligent on the part of the caregivers attending to the baby’s first hours of life. Justice is best served in the form of a successful recovery against the liable parties.

What is hyperbilirubinemia?

Bilirubin is a natural substance produced during the body’s regular breakdown of old red blood cells. Bilirubin presents as the yellow pigment found in the bile, blood, urine and feces of all humans. However, when a baby’s liver is not able to properly process bilirubin, hyperbilirubinemia can develop, causing  the yellowing of the skin and eyes seen in jaundiced babies. If the condition continues to progress without treatment, the bilirubin can collect in the brain and other tissues, causing a form of brain damage known as kernicterus that can lead to hearing loss, seizures, eye movement disorders, physical abnormalities, permanent conditions like cerebral palsy, and even death.

Signs and symptoms

Doctors are trained to recognize the signs of hyperbilirubinemia and should catch, treat and monitor any jaundice before irreparable harm occurs to a child’s brain. Once the whites of a baby’s eyes and the pigment of his or her skin begin to appear yellowish, brain damage may already be developing. This is why it is so important for doctors to be on the lookout and ready to take corrective measures at the first signs of hyperbilirubinemia, which include poor feeding, lethargy, and a yellow pigment that typically appears first in the face and moves to the extremities.

The presence of jaundice can be initially assessed by blanching the baby’s skin under bright lights to reveal the color of the tissue, and to examine the skin for yellow tint. Because the signs of jaundice can vary from patient to patient and among ethnic groups, and may also mimic other conditions, doctors who notice symptoms should always run the necessary blood tests to determine whether hyperbilirubinemia is present.

Causes & risk factors

Jaundice occurs for several reasons. Many times, it is simply because the baby’s liver has a natural learning curve as it begins to process bilirubin, since newborns produce bilirubin at twice the rates of adults, for the first two weeks of life. Other times, it could be the result of an undiagnosed blood or liver disorder, or an infection.

Other risk factors include:

  • Infants with diabetic mothers are more at risk for developing hyperbilirubinemia, as are premature babies. Nearly 80 percent of preterm infants develop jaundice, compared with 60 percent of full-term babies. Despite the high percentage of babies who develop jaundice shortly after birth, most infants do not have any underlying disease.
  • Breastfed babies are slightly more at risk of developing jaundice because the components of breast milk may encourage the reabsorption of bilirubin in the child’s intestines.
  • Infants who are having difficulty nursing may also be at risk for hyperbilirubinemia because it can lead to dehydration, decreased urine output and thus excess bilirubin. Typically, jaundice due to breastfeeding problems occurs in preterm babies who have not developed the necessary suckling skills.
  • Fetal-maternal blood group incompatibility is also a substantial risk factor for hyperbilirubinemia, as is bruising, and trauma associated with a forceps or vacuum-assisted delivery. Newborns whose meconium passage is delayed also have an elevated jaundice risk.
  • All infants who present with these risk factors should be closely monitored by their physician for hyperbilirubinemia. A doctor who ignores risk factors for jaundice could potentially be liable for birth injuries associated with the condition.

Paying close attention to when jaundice develops and when symptoms begin to present can aide a doctor in making a hyperbilirubinemia diagnosis, since certain types of jaundice follow a typical timeline. Breastfeeding-related jaundice, for example, usually presents in the second week of life, while jaundice related to infection might present on the third day of life. The most dangerous form of jaundice typically presents within the first 24 hours after birth.

Treating hyperbilirubinemia

Hyperbilirubinemia is typically treated with special phototherapy blue spectrum lights, since bilirubin absorbs light and decreases the more it is exposed to light therapy. Less commonly, severe jaundice is treated with a blood transfusion, which replaces the baby’s damaged blood that contains excess bilirubin with new, fresh blood.

In addition, doctors will also treat any underlying conditions that are contributing to hyperbilirubinemia. For example, a physician will prescribe antibiotics for an underlying infection. If bilirubin levels are elevated only minimally, no therapy may be necessary.

A birth injury lawyer can help

The birth injury lawyers at Eisbrouch Marsh understand the years of health challenges facing a child who has suffered brain damage or cerebral palsy as the result of untreated hyperbilirubinemia.

We have  extensive experience handling birth injury cases and years of success winning awards for our clients. We offer complimentary consultations and charge no fees unless we win compensation on your behalf. Call toll free: 888.674.3931.


  1. American Family Physician, Hyperbilirubinemia in the Term Newborn, http://www.aafp.org/afp/2002/0215/p599.html

  2. Lucile Packard Children's Hospital, Hyperbilirubinemia and Jaundice, http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/hyperb.html

  3. WebMD, Jaundice in Newborns (Hyperbilirubinemia) - Topic Overview, http://www.webmd.com/parenting/baby/tc/jaundice-in-newborns-hyperbilirubinemia-topic-overview