More and more the Wall Street Journal is becoming a forum for hot child health issues of the day. This morning the front page tells the story of one child who suffered from a rare complication of newborn jaundice called kernicterus. Kernicterus occurs early in life when excessively elevated bilirubin in the blood damages the developing brain. While the exact incidence of kernicterus is unknown, some experts suggest that the incidence may approach 75 cases per year in the United States. Sue Sheridan, the child’s mother, has embarked on a national campaign to prevent kernicterus and this morning’s feature details her mission.
For the uninformed, one might take away from the passionate efforts of Ms. Sheridan that “one simple test” is all it takes to prevent anything bad from happening to a baby. In truth, the appropriate management of jaundice in the newborn must involve the careful consideration of a number of variables including a baby’s age, perinatal history, what they’re feeding, bilirubin level, rate of change, and blood type to name but a few. Jaundice in the newborn always warrants attention but management isn't always straightforward.
While my heart goes out to Ms. Sheridan and her son, the WSJ feature resurrects the timeless debate of when, how far, and at what cost we should take public health measures to identify rare problems. No system for early identification of preventable disease is perfect but a good pediatrician’s judgment likely remains the best means of identifying and treating jaundice in babies.
And by the way, no one rides the main stream media for free. It seems the kernicterus-prevention media campaign has been funded, in part, by none other bilirubin-testing device maker Respironics, Inc.