High Bilirubin numbers--anyone with experience or resources?

[jamsmu]

A friend had her baby this week. Apparently, his Bilirubin numbers have been high, but they let them take him home yesterday. Today, the nurse drew blood and his numbers are rising.

I really don't know anything about this and I'd love to learn more, provide assistance and resources for our friends. Please share suggestions....

Thanks!

[octmom]

nak, so will be brief

My DD was jaundiced and premature. She had heel pricks to check bili levels for several days and was treated at home with a bili-blanket (phototherapy) for about a day and a half at the end of her first week. I was stressed at the time, but in hindsight, it wasn't terrible. The hardest part was getting DD to eat enough. Jaundice (and prematurity in my DD's case) can make for a very sleepy baby. If your friend has the same issue, suggest stripping baby down to his diaper for feedings, lots of skin-to-skin contact, and rubbing cool wet washcloths on baby's head and feet. Our pediatrician said some parents even put ice in baby's diaper (!), but we never resorted to that.

ETA: My DS (not a preemie, in fact a big overdue baby) was slightly jaundiced too, but did not require treatment. Since we didn't find out if we were having a boy or a girl when I was pregnant with him, we had lots of yellow clothes. He looked awful in them! Needless to say, I did not dress my DD in those clothes when she was a newborn. ;)Tell your friend not to be alarmed if her baby has a yellowish hue for several weeks, even after treatment. It can take a while to disappear completely.

Also, a friend had a baby the day after my DD was born. She said that he had something called "breastmilk jaundice", which is different than the type of jaundice my kids had. I think it has soemthing to do with an enzyme in some women's breastmilk causing the bilirubin to not break down effectively, but I could be mistaken. She had to use formula for a couple of days and pump. I think she was able to freeze the pumped milk and give it to her DS once his bili levels came down.

Jerilyn
DS, Sean 10/03
DD, Katie 3/06

"Baby makes days shorter, nights longer, home happier, and love stronger."

[annasmom]

My dd was under the Bili-lights for a week + in the hospital when she was born, but like a PP's dc, she was a preemie. I do remember my niece was sent home from the hospital with high bili numbers and her doc told my sil to undress her and get her into the sunlight (same concept as the bili-lights).

That is about the extent of my knowledge. Honestly your friend should probably use this as an opportunity to get to know her new pediatrician and give him/her a call!!

[bubbaray]

My DD had jaundice at birth, I couldn't tell you her numbers though (its all such a blur!). My OB told me to nurse LOTS and to keep her cool when nursing (ie., so she stays awake, doesn't fall asleep at the breast). The bilirubin is something to do with the breakdown of excess red blood cells from the placental blood. From what I remember, nursing lots helps the baby's body dilute the bilirubin and get rid of it. I don't know if FF'g works the same or not. I've heard others having their babies under bili-lights or keeping them in the sun for a while, but didn't have to do either with DD.

HTH


Melissa

Maya Papaya!
http://lilypie.com/baby2/040411/3/4/1/-8/.png[/img][/url]

[nfowife]

My DD was not checked for jaundice that I know of in the hospital before we were discharged about 36 hours after delivery. However, about 36 hours after that I noticed she was really yellow looking and not having as many diapers as she should be having, so I called my ped. and she sent us to the hospital to have a blood draw to check it. Her numbers came back VERY high (25!) so we were admitted (well, DD was admitted but she was put in a postpartum room and I stayed with her the whole time for nursing, bonding, etc.) for phototherapy. My milk had still not fully come in (we did weigh, feed, weigh for each feeding to see how much she was getting) until the morning after she was admitted so before then (for about 14 hours) after I nursed her on both sides, we would cup feed her 1-2 oz. of formula to encourage her to have the diapers. I was extremely upset and stressed about this but the hospital nurses were so great about it and very encouraging about letting me nurse as long as I wanted to however often I wanted to. I just had to call them in to weigh DD so I could feed her, and then call them back when I was done to weigh her again and then we'd cup feed her some formula. The next morning it was clear my milk had arrived (hello porn star boobs!) and we did a few more weigh-feed-weighs to be sure she was getting at least 2 oz. per feeding, which she was by then so we discontinued the supplements and I just nursed her the rest of the time. Her bili was checked each morning and the ped would come by each day to update me on the status. It was coming down but slowly. We were in the hospital from Friday-Monday afternoon and when we left her levels were 14 and continued to get better on their own over the next few days- although it takes weeks for it to fully go away.
My DD was not a preemie, she was 5 days late and almost 8 lbs. at birth. However, she was a vacuum assisted delivery which caused a big bruise on her head. Bruising like this can increase the likelihood of jaundice because the blood goes to the bruise instead of being excreted through the poop and skin, so that along with my milk showing up on the 5th day just made it more difficult for DD to get rid of the bilirubin.
So that's our story!


http://www.windsorpeak.com/dc/user_files/33217.jpg

[mamato1]

My DS was born at 37 weeks and had jaundice. A home nurse came every day and did a heel prick to check bili numbers. We had to do the phototherapy blanket at home. At the time I felt like it was so traumatic, I guess I could blame the hormones because I cried, and cried and then cried some more. But looking back it just was not such a big deal. Brendan just looked like a Glowworm (remember those!)wrapped in his photo therapy belt. To this day I regret not sending someone to ToysRus to buy one to put next to him for the perfect Kodak moment. Anyway, the key is to nurse alot, I mean alot. The previous posters gave good suggestions for keeping baby awake to feed. I ended up having to supplement with some formula and was really upset about that. But, the home nurse gave me a small syringe with a long skinny tube. I would fill the syringe with formula and then lay the tube along my nipple and just gently depress the plunger as he nursed.

HTH

Chris

Mama to Brendan (aka Boomer) 01/04


http://b3.lilypie.com/FnI6m5/.png

[HIU8]

My DS was jaundice with very high bili levels. He became jaundice about 24 hours after we took him home (he was 10 days early, but almost 7 lbs.). Anyway, his ped had visiting nurses come to the house, he was heel pricked lots and used a biliblanket for 4 days. He was very tired and had a hard time feeding. We kept him in just an undershirt and the biliblanket for the 4 days and his levels went down.

HTH
Heather
DS 11/27/04

[american_mama]

You know, I'm still fairly clueless about my DD's jaundice. I think a high number would be something in the high teen's or 20's; my daughter's high was at 15.3, but they treated her like it was a big deal. I suspect it wasn't and the hospital was just very interventionist. She did have the complicating factor of ABO incompatibility, a fairly common and treatable problem, and one which I am sorry to say I still don't quite understand.

Many people link breastfeeding and jaundice, but don't let that discourage your friend. I followed the hospital pediatrician's advice and suspended breatfeeding for 24 hours or so, although I never understood why. After the crisis had passed, I got advice from others (including two pediatricians) who said you do not usually need to suspend breastfeeding. So your friend can probably find reasons for either approach.

Here are my posts about the subject, which are helpful for the links in the responses:
http://www.windsorpeak.com/dc/dcboard.php?az=show_topic&forum=37&topic_id=141113&mesg_id=141113&listing_type=search
http://www.windsorpeak.com/dc/dcboard.php?az=show_topic&forum=86&topic_id=14489&mesg_id=14489&listing_type=search

[mharling]

Look for Jaundice in the A-Z section on www.askdrsears.com It's a quick read and has lots of great information.

Mary - Some days work. Some days don't.

[lmintzer]

Joshua was born at just under 36 weeks. He was discharged with me after 2 days (levels were normal at the time), but by morning 5, he was pretty yellow. We had a peds. appt. that day. Sure enough, his bili was at 17.5. It was low enough for phototherapy at home but high enough for a very laid back ped to react quickly. He was on the phone with us as soon as they had the test results, and the service with the tech. and the bili blanket was at our house within a few hours. We were told he'd probably have to be under the lights for a few days. We had a re-check scheduled 36 hours later, and we were super vigilant about really keeping him wrapped in the blanket. I only took him out to change his diaper. It was kind of hard--he was tethered to the wall with this vacuum-cleaner hose-looking thing, but we managed it so he could be either in his bassinet or in a big comfy chair. I slept with him on me in the chair one night so that he could remain wrapped up but still near me.

Jaundiced babies are typically sleepy, so despite my worries about how he'd feel being wrapped in this thing, he was totally fine. The day and a half passed quickly, and he was doing so well by his check that the ped actually discontinued the use of the blanket early.

I know it's scary, but jaundice is easily treatable -- it just needs to be taken seriously if the numbers are high enough.

[kboyle]

charlie was born at 35wks and was slightly jaundice when we left the hospital 48hrs later, but we were told to just feed him every 2 hrs, wake him up & keep feeding. for our 1st ped appt (2-3 days later) the bili levels had risen and we went home with a biliblanket & he was on it for about 10 days and was fine after that.

max on the other hand was born at 36wks and left the hospital with his levels at a 14 and they had a biliblanket delivered to us that evening. we were told again to wake to feed & feed every 2 hrs no matter what. we had his first ped appt the next day (so 3 days after birth) and his levels had lowered to a 12. again we were told t stay on the blanket & push his feedings. the next day they pricked his heel again and the levels were at a 16, so they told us to keep doing what we were doing, they told us to come back the next day (sat am) to get his level checked again, this time the level was at an 18 and the doc told us that we could go to the ped er that evening for intense phototherapy (mini-tanning bed) or just wait till morning to go to the hosp to get his bili levels checked again...we opted to just go to the hosp that night so that we could just phototherapy him and get his levels down asap. we got there, they checked his levels (which didnt come back for another 3 hrs) and they told us to go home and get it re-checked on mon. the chief ped told us that the level was at a 20! but that the on-call ped at my dr office told us to just get it re-checked after the weekend on mon. the chief ped told us that in his opinion he would admit us, i told him i wanted max to be admitted, the other dr told us to go home. i was sooooo pi$$ed. the chief told us that he couldn't really admit us since my dr office told him not to, but that max would be ok, till mon. when we got home i called my ped even though he wasn't the one on-call (i have home #) i told him that we were sent home per the on-call dr (his partner), he told me it'll be ok & just get him re-drawn again early am on mon and he'd call me late afternoon, plus he was on-call the next day (sun) and on mon night so if anything happened, he'd be available. on mon we got re-drawn and he called us right after dinnertime and his levels had risen to a 25! great, it could've been gone by now if we would've just gotten admitted 2 days ago. so we trudge back to the ped er & the chief was on again...he just shook his head and said that he told the on-call doc to admit us. finally, around 8p we were in a room & max was in his tanning bed. they set me up with a pump and some formula. i was aloud to take him out every 2 hrs to nurse for 10 min & then bottle feed him formula for 10 min...he was only aloud out for 20 min total including diaper change. i was to supplement him with formula to make sure that he was actually eating something. i also pumped right after i put him back in to increase my supply & to start building up a little stash. they checked his levels sometime in the middle of the night and when they told me the level it had gone down a point or two. then they re-checked it again around 9a and told me they should have the results by noon and if it had gone down again that we could go home. just my luck, it went up 3 points, so now we were 1-2 points higher than when we came. i thought i was going to explode. they re-checked him again at around 3pm and we got the results around 6p and we were out of there by 7:30p. they re-checked him a couple more times the next week, but the levels slowly came down. max spent his 1 wk mark getting tan at the hospital. i was 1 wk post partum & back in the hospital...i'm amazed i didn't spend it crying. :) oddly enough, it wasn't too bad, charlie wasn't around climbing on top of me jealous, i didn't have to make any of my own meals (this hospital has GREAT food) and the nurses woke me up everytime i had to nurse, so i just slept for 1 day straight!

i'm surprised that i actually remember this, especially his levels, it actually seems so fresh in my mind. probably because i was sooo mad that i could've just re-admitted him a few days before and not had to deal with it longer than i should have. i think max had a total of 6-8 pricks on each heel, they didn't even go back and forth anymore, they just picked the heel that had the least pricks or the one that was heeling the best, it was really quite sad. all of his newborn socks had little blood stains on the heels.

here's my little guy tanning on his 1 wk mark!
http://www.windsorpeak.com/dc/user_files/33229.jpg

doesn't he look thrilled!
http://www.windsorpeak.com/dc/user_files/33230.jpg

[Melanie]

Yes, BTDT! I believe the highest they want them to go is 20. Our son got to 18 then my milk came in and they plateaued and plummeted. Having his system process food helps to rid it of the bilirubin. Also exposure to UV light (Even outdoors or lain next to a window, the less clothes teh better if it's warm enough) will do it. Unfortunately it was cold and rainy in November and I was a paranoid mom who didn't want to dress him too lightly. LOL. It all worked out in the end, though. No need for hospitalization, bili lights or formula.

There is also something called a bili-blanket that she could wrap baby in so it can be held instead of laying all alone with it's eyes covered under those lights. My ped felt it didn't do a whole lot of good and let us wait it out with the realization that if it got to 20 back to the hospital he would go.

She will likely need to take baby in for daily heal-pricks which are also hard on new mommies.

It may also make her baby sleepier than normal, thus creating more BF problems and her milk to come in slower. =( She can do it though, this problem will likely pass very quickly!

ETA: Ds was term and otherwise healthy. We have ABO incompatibility. I was quite worried about this with Dd b/c I was guaranteed to have the ABO incompatibility again, HOWEVER, we did not cut her cord until it stopped pulsating, and she had NO jaundice! Ds was an unexpected hospital birth with mec. and the staff cut it immediately.

[jamsmu]

Thanks so much to everyone who responded to this thread. I have learned so much and was able to talk with the Daddy tonight and actually seem intelligent!

The baby was admitted today back into the hospital. (He had stayed in extra day, came home Thursday and went back today.) Mommy is staying with the baby overnight and they'll do another heel-prick tomorrow. Mommy is a great BFer (she nursed her first DS for well over a year) and completely devoted to doing the same for this one. They have wonderful attitudes and outlooks, it was uplifting to talk to the Daddy tonight. They are, however, really nervous because the nurses told them yesterday that they should be prepared for the numbers to go up again... and then they started reading or being told (I'm not certain which) about brain damage. Its just so scary to even imagine!

Ironically, my youngest sister was born jaundiced and was under the lights for a day or so--I was just too young then to really "get" it. My mom basically explained it as Debbie is in an incubator, like the baby chicks at school.