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When a baby is born prematurely the chances of birth injury and/or birth defect are high. The management of care, and treatment of a severely premature infant is fraught with difficult decisions that may well affect the long term outcome of the child.
One of the causes of neurodevelopment impairment amongst severely pre-term babies is jaundice; a yellowing of the skin common in newborns. This condition is caused by a build up of bilirubin, a substance produced when red blood cells are broken down. A healthy newborn's liver will remove bilirubin over the course of a few days without medical intervention and with no long term ill-effects.
However, if the baby's liver fails to remove the bilirubin, a potentially toxic level can accumulate resulting in a condition known as hyperbilirubinemia. Without treatment this condition can result in severe brain injury, which may lead to cerebral palsy, profound intellectual and developmental disability, blindness and severe hearing loss.
Primary treatment of hyperbilirubinemia involves exposing the infant to a high intensity light source; phototherapy. The light penetrates the skin and converts bilirubin to a substance which is then expelled harmlessly in the baby's urine.
Currently, clinical practice guidelines exist for the evaluation and treatment of high bilirubin levels in infants born at or near term. However, until a recent study was carried out in the US, there had been little research into the treatment of high bilirubin levels in premature babies.
The study was carried out by researchers in the Neonatal Research Network of NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Results from the study were published in the New England Journal of Medicine on 30th October 2008 and reported comprehensively on the Medical News Today website.
Results of the study led the authors to conclude that infants from the larger preterm birth weight category of 751 to 1000 grams (1lb 10oz to 2lb 9oz) should be considered for "aggressive treatment" of high levels of bilirubin using phototherapy. Such aggressive treatment would occur once the bilirubin levels reach 5 milligrams per decilitre of blood. The study found that this did not appear to increase the chances of death, and appeared to reduce the rate of neurodevelopmental impairment.
In smaller premature babies, weighing 501 to 750 grams (1lb 1oz to 1lb 10oz), the use of phototherapy treatment to reduce high levels of bilirubin, in an attempt to prevent neurodevelopmental impairment, has to be carefully considered against the possibility of an increased risk of infant death as the treatment of smaller babies appears to carry acertain amount of risk.
Rosemary Higgins, M.D., the NICHD co-author of the study said, "These are extremely frail infants who may have a number of health problems. The bilirubin level shouldn't be considered in isolation. It's just one aspect of an infant's overall health status that needs to be carefully evaluated so that the best treatment decisions possible can be made for that individual."
The NICHD sponsors research on development, before and after birth; birth injury and family health issues. For more information, visit the Institute's Web site at www.nichd.nih.gov.
YouClaim and birth injury compensation
If you or your baby has suffered birth injury, or if you feel the care of your newborn has been mismanaged, leading to personal injury, you may be eligible for compensation. At YouClaim we understand the pain and distress of such claims and our medical negligence solicitors are amongst the most experienced in the country. All our legal professionals are governed by the strict regulations of the Law Society.
Whilst the complexities of birth injury medical negligence claims prevent us from stating outright that you will not be charged any legal fees, we always advise you of any charges before you commit to them and in a won case we will fully reimburse you.
If you wish to discuss a birth injury compensation claim, please call our confidential helpline now on 0800 10 757 95 or you can request a more convenient time when we can call you back. Alternatively, fill in the online claim form and we will look into your compensation claim before we call you to discuss it further. Above all, at YouClaim we are here to help.
