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Thread: Need Help with Jaundice/ ABO related

  1. #1

    Default Need Help with Jaundice/ ABO related

    I just had my 4th baby and we had a positive Coombs test. The bilirubin was higher than they would like to see so when we went home they sent us with a blanket and had a nurse stop by every day. The bili level went up slowly, a point a day for 3 days. It got up to 15. At the same time his hemoglobin dropped. They explained his blood cells were attacking themselves because of the ABO. They readmitted us to the hospital and we stayed there for 3 days on a double bank. There is continued suggestion that he is not getting enough milk. I suspect that was part of our admission reason. Now the nurse was out every day and he gained every day he was home. In the hospital, they weighed every diaper, watched my latch, put him on an IV and had me pump so they could check output. His levels only dropped to 11 but they released us with a blanket and a nurse. In 3 days his level has climbed a point, he is at a 12. He is still gaining weight. Now he is 10 days old and the dr called us in. She wanted me to quit nursing because she thinks it is "output" related. I told her I refused to quit nursing. She said I must start expressing so I can measure because she has to rule out output and she is almost sure that is what it is.
    I am on my 42nd month of BF. I had just weaned a few months before because of contractions and when I delivered, my milk was in. I even showed the LC and expressed right after delivery. I was pumping excess after 3 days because I have always produced a lot of milk. When he was on IV's I pumped 6-8 ounces at a time and filled the freezer at the hospital. I know it is not output, he has tons of wets and 5-6 poops a day. My drs next plan is to check for food allergies and have me eliminate foods. She said allergies can cause jaundice, I had not heard that. After that she says the next possible cause is he is not able to digest breastmilk, she said that was breastmilk jaundice. They will not check hemoglobin anymore or anything else. Has anyone else had these issues? Won;t this pass on it's own? Can a baby be unable to digest breastmilk? When I told her that we have had allergy issues before and done the elimination before, that baby had gas, spit up, had digestive issues and didn't have jaundice, she said that allergies could bring on jaundice but have no other signs.

  2. #2

    Default Re: Need Help with Jaundice/ ABO related

    Sorry so long. My continued argument is that I know he is getting enough milk and they watched me like hawks for 3 days and the baby has been weighed every day since birth. He has also had his blood, including electrolytes tested every single day and when we were in the hospital, 3 times a day. I feel like they think I am neglecting him. The dr asked today if I knew how to tell if my breasts were empty or full and if I pumped after to see if he was really eating. I have nursed 4 children for 42 months so far and have never had issues. I am no amateur. Thanks for help

  3. #3
    Join Date
    Jun 2008
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    Default Re: Need Help with Jaundice/ ABO related

    My son and I also had ABO incompatibility, and he was in the hospital for 8 days in special care. He had horrible jaundice, which was explained as a direct result of the blood issue, and it took a while--I'd say 2-3 weeks--to clear. He was so sleepy that nursing took forever to get going because he just couldn't stay awake to do it, but it sounds like your son is gaining well. The suggestion of pumping to measure output does not sound like a valid way to measure output to me, plus it sounds like his weight gain is fine, so based on my experience I'd get another doctor if that's an option for you; it just doesn't sound like she knows about this.

  4. #4
    Join Date
    Feb 2012
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    Default Re: Need Help with Jaundice/ ABO related

    My pedi told us about the breastfed jaundice but was rather unconcerned about it and just told us to watch out and if he was becoming less alert or more jaundiced looking to come in. She actually even said in otherwise healthy babies she thought that there may be something beneficial about the breastfed jaundice but had never seen any confirmation of it. However my DS's levels went up for just a few days and then gradually went down and didn't appear to be going back up. No one ever tested the levels again so they may have gone back up. They used a chart to make sure that the levels were acceptable (a number that changed daily bc it was based on age and weight). Once it was clear his level was staying in a certain range no one was concerned. He is 8.5 wks and still has a tinge of it but the pedi said it could last up to 10 or 12 weeks.

    I kept DS in ambient sunlight as much as possible or you could keep using the blanket if you still have it. It won't hurt. Of course the ABO does complicate things and I don't know that much about that. But I would think if his levels are in an acceptable range and otherwise healthy he would be fine. Is seeking a second opinion an option?

    Best of luck.

  5. #5
    Join Date
    May 2006
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    19,878

    Default Re: Need Help with Jaundice/ ABO related

    Welcome and congratulations on the new baby! I am sorry you've had such a tough time so far. It sounds like you know a lot more about breastfeeding than your baby's doctor does. Pumping is not a good way to measure supply nor is it a good way to evaluate whether or not a baby is getting enough to eat. I have never heard of allergies causing jaundice- I am guessing that would be quite rare! And as for "breastmilk jaundice" being caused by a baby being unable to digest breastmilk- that just has me because being unable to digest breastmilk is incredibly rare, life-threatening, and moreover it is NOT what causes jaundice! This link discusses jaundice and breastfeeding in more depth: http://www.nbci.ca/index.php?option=...tion&Itemid=17

    I am that seeing a different doc sounds like a good idea. I know that my pediatrician probably wouldn't freak out over bill levels that are in the 10-12 range, although I'm sure she'd want you to put that baby in a sunny window, nurse him as much as possible, and make sure he gets woken up at regular intervals if he's a sleepy guy.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6
    Join Date
    Nov 2010
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    Texas
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    Default Re: Need Help with Jaundice/ ABO related

    i would also ask for a different doctor. i'd probably demand it. moreso since this is "not your first rodeo".
    my LO also had ABO incompatibility and jaundice. We had to stay an extra day in the hospital and were monitored closely but it was never suggested to me by him to not breastfeed or to give up breastfeeding b/c of jaundice. I understand maybe having to supplement if the weight becomes a problem, but that would not mean having to give up breastfeeding that makes no sense to me at all.
    i second the idea of a sunny window (that's what our pedi told us to do at the hospital).
    Christine
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  7. #7
    Join Date
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    Default Re: Need Help with Jaundice/ ABO related

    How strange that your doc is giving you, an experienced mom, such a difficult time. I'd get a second opinion myself and keep on trucking. Sounds like baby is doing great.

    Pumping is NOT an indicator of output. I have tons of milk when I nurse directly, but pumping can be a different story.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  8. #8
    Join Date
    Feb 2012
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    Milwaukee
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    Default Re: Need Help with Jaundice/ ABO related

    Wow... New doc would be a good idea. My baby had Coombs as well. But not as bad as yours. An 11 and 12 is not alarming! My ped didn't do anything until reached a 14.8 (because he says 15 or greater is what to worry about) sunny window with as much skin exposed safely (temp wise) then I had the blanket on for about 24 hrs or so.. Level dropped a point or so and then we just monitored for a while. But I did have to supplement with formula for a while until my milk came in. My ped did say that bm can make jaundice worse when we were talking about it.
    Can't stop smiling because my lil Miguel is just so amazing! Since 1/29/12 my heart is no longer my own!

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