What is a significant risk for an infant with bilirubin levels exceeding 20 mg/dL?

When bilirubin levels exceed 20 mg/dL in an infant, one of the most serious risks is the development of kernicterus. Kernicterus is a form of brain damage that occurs when excess bilirubin in the blood crosses the blood-brain barrier and accumulates in the central nervous system, leading to neurological damage. This condition can occur when severe hyperbilirubinemia is not promptly treated, and it can result in a variety of long-term problems including developmental delay, hearing loss, and movement disorders.

Bilirubin, a product of the breakdown of red blood cells, is typically processed by the liver and excreted from the body. When levels become excessively high, as seen above the threshold of 20 mg/dL, the risk of bilirubin toxicity increases significantly, hence the importance of monitoring and managing bilirubin levels in newborns. Kernicterus represents a severe complication of untreated hyperbilirubinemia, highlighting the need for timely medical intervention in cases of high bilirubin levels.