Help: newborn niece has blood incompatibility biliribun

[Naranjadia]

and also some infection.

She was fine at birth this morning, but is now in NICU. This is my sister's 2nd child. Anyone with info and perspectives on this - I would be grateful to hear.

[JBaxter]

Is that like RH factor disorder?

[brittone2]

My SIL had ABO incompatibility (I'm assuming that's what your family's situation is?) with some of her kids but it was quite a few years ago. I think they needed phototherapy but I don't remember much more than that.

I hope everything works out so that they are healthy and on their way home soon :hug5:

[Naranjadia]

I don't know - I believe my BIL is B and she is A, or vice versa.

[bubbaray]

Is it this: http://www.nlm.nih.gov/medlineplus/ency/article/001600.htm

[lilycat88]

DD had this when she was born. I'm type O+ and DD is A+.


With an ABO incompatibility, a mother makes antibodies against her baby's blood type. It doesn't happen if the mother and baby have the same blood type or if the baby is type O, since in that case, there is usually nothing to make antibodies against. These antibodies, if the mother is type O, can cross the placenta and can break down the baby's red blood cells after she is born, leading to jaundice and anemia.

Many times, the babies don't need any treatment at all. If they are really jaundiced, phototherapy will take care of it. The mother's antibodies are cleared out in a few days.

If there is an infection, I'd say that is the reason for the NICU more than the ABO compatability.
Good luck to her.

[Naranjadia]

Thanks for the responses.

Susanna, that is helpful to know about the infection being more likely the cause of the NICU.

I understand in some cases transfusion is required. I am just hoping this isn't the case. I am waiting to learn more from my BIL. My sister is just beside herself.

[klwa]

Niece had this. Mom was O, DN was B. She was pretty jaundiced, and did have to be rehospitalized a few days after birth even with the home bili lights. Now DN is a happy healthy almost 9 year old. She could very well be in the NICU for the bili-light treatment, especially depending on the level NICU at her hospital. (DN was in the NICU at their hospital, but it's a low level NICU in a small hospital.)

[elaineandmichaelsmommy]

so this was us with dd1. except that it was 7 years ago so I'm sure our nicu experience was differant.

the blood type incompatablility isn't the problem because I was incompatable with dd2 and ds. The child is most likely in the nicu due to infection that most likely will clear up in a few days with antibiotics. HOWEVER- a sick baby would probobly have a harder time dealing with the biliruben than a healthy baby. so this has most likely caused the bad jaundice.

all of my children had some degree of jaundice. was this cause by the rh incompatiblity? Maybe maybe not. but dd1 was the only one who needed to be under phottherapy lights. dd2 and ds only needed the shutters/shades open in the rooms and to be put in the sunlight.

your sis most likely had shots of rhogam treatments for this so a transfusion won't be necessary.

I know it's scary to see any baby in the nicu but baby will most likely be fine.

good luck

[Naranjadia]

Thanks. I just got a text that she is getting IV immunoglobulin to coat the bilirubens and is under the lights. BIL also think she is getting antibiotics. They are expecting her to be there for a week.

[american_mama]

DD2 had this and I posted about it here, five years ago almost to the day, but I confess I have never fully understood it. The easiest thing to understand is what it is not: it is NOT Rh incompatability, which is related to whether your blood is + and -, can be treated in advance with a Rhogam shot for a pregnant mother. People hear blood incompatability and newborn and think that's what you're talking about: ABO incompatability is different and milder.

There is a major blood transfusion that is, I believe, the ultimate treatment for ABO incompatibility, but is rarely needed. I doubt it will come to that for your niece.

My DD2 was born overseas in an academic medical center that supposedly treated things rather aggressively. She received immunoglobulins, although I strongly suspect that had she been in another hospital or a US hospital, she would not have received that treatment. She was sent to the pediatric newborn unit of the hospital, (lower level care than the NICU), and was in an isolette under 24 hour lights for 2-3 days, wore the foam "sunglasses" and had an IV to hydrate her to make up for the dehydration caused by the lights. The gauze on the IV was so big it looked like she was wearing a cast on her whole arm, and she had three sensors on her chest for temperature/heartbeat, etc. My heart nearly stopped when I first saw her through the glass viewing window: "Is that DD2?", I whispered to my DH, not believing that I couldn't recognize my child nor that my healthy, full-term newborn was now crying like mad in an isolette, surrounded by medical paraphenelia.

The peds also told me to stop breastfeeding for 2 days (controversial advice which I think is often considered outmoded). If your sister is told to stop breastfeeding, she should really ask hard questions about that advice, especially if she is not an experienced breastfeeder who may have a hard time pumping and then getting back (or whose baby may have a hard time) getting back to breastfeeding once it's been interrupted. Breastmilk tends to make jaundice last a little longer, but if the baby is otherwise responding, your sister should ask does a few extra days of improving jaundice really matter.

Just so you have some idea of the numbers involved, my recollection is that my DD's highest bili level was under 15 (maybe more like 12), and they usually don't worry until it's in the high teen's or over 20. My US pediatrician says immunoglobulins are very expensive, which is one reason they are using infrequently, and that the bili numbers I recall just do not warrant the level of treatment DD received. I'd really like to know the numbers for sure, but the medical records from her birth are exceedingly hard to get due to the foreign country, foreign language, various residents/physicians we saw, and an international move when DD was 5 weeks old.

DS, born three years after DD, may have had ABO incompatability. I don't strictly recall if the peds said that, but he was born in a US hospital and was under lights in my room for 2-3 days and stayed an extra day. The peds treated him a bit more aggressively due to his bili numbers, the unclear history of DD, and the known fact of her getting immunoglobulins (one ped called that "pretty impressive" as in, a big deal.)

This is very treatable, so your niece is likely to be fine. Many mamas have gone through so much worse, but it was a shock for me to have my baby separated from me and for my healthy baby to suddenly be receiving serious medical care. Your sister may be feeling the same. DD and I had no trouble picking up breastfeeding, but had that been difficult after the 48ish hour suspension, I would have been devastated. In addition, the hardest thing for me, then and now, is not really understanding what ABO incompatability is and how it happens. If your sister is a detail person like me, you might send her links or printouts of reliable web pages that explain ABO incompatability and basic blood terminology (anitbody and antigen, specifically).

[ellies mom]

:yeahthat:

With ABO incompatibility, the mother (usually type O) has made antibodies for either A and/or B type antigens. It doesn't always happen during pregnancy, apparently she can be exposed to the antigens through things she has eaten. ABO incompatibility is not as serious as Rh incompatibility because the ABO antibodies are a different type than the Rh factor antibodies and they are much less likely to cross the placenta.

[Naranjadia]

Thank you American Mama and Veronica! I will be sharing this great info. I talked to my sister this morning. They are having her continue breastfeeding - yay! And she is doing so every 2 hours. She had a brief period where her bili levels were rising when she wasn't latching on as well as she did right after her birth, but she has resumed latching, so that's good.

So far it's status quo, but they did tell my sister and BIL that the levels might rise before they fall, so they were expecting that.

[Naranjadia]

Thank you American Mama and Veronica! I will be sharing this great info. I talked to my sister this morning. They are having her continue breastfeeding - yay! And she is doing so every 2 hours. She had a brief period where her bili levels were rising when she wasn't latching on as well as she did right after her birth, but she has resumed latching, so that's good.

So far it's status quo, but they did tell my sister and BIL that the levels might rise before they fall, so they were expecting that.