I have a beautiful new granddaughter, which is thrilling for the whole family. Less of a cause for rejoicing is the fact that she has jaundice caused by ABO incompatibility.
Ours is a long-distance relationship which has lent a certain nerve-wracking quality to her first week of life.
I can't be there, can't see my daughter or my granddaughter, so I've handled my anxiety and questions by heading to the internet for information.
I was familiar with jaundice but even though I've had five children I'd never heard of ABO incompatibility before.
I knew that a baby with jaundice has a yellow cast to the skin and eyes from too much bilirubin in the blood. Bilirubin is a waste product that results when red blood cells break down.
Jaundice occurs when bilirubin production is more than the tiny liver can handle.
ABO incompatibility is a hemolytic disease. That means red blood cells break down faster than normal. Jaundice, anemia and in severe cases, death can result.
In most cases, though, ABO incompatibility is mild and treatable. Most often, the condition occurs when a mother has type O blood and her baby is either type A or B. When the baby is premature, there is greater risk for more severe ABO incompatibility.
While a woman is pregnant her blood does not generally mix with her baby's but events like birth, miscarriage or trauma can cause some mixing. This causes antibodies against the baby's blood to be manufactured and transmitted across the placental membrane to the baby's circulatory system.
This is the point where some of the baby's blood cells may be destroyed, creating bilirubin. Too much bilirubin can be more than the baby's waste elimination can get rid of. Jaundice results.
A few weeks after birth, anemia can develop due to the speeding up of red blood cell breakdown from Mama's antibodies. Blood tests monitor this situation.
If jaundice is mild, nothing need be done. But high bilirubin levels need phototherapy treatment. Extreme cases may require blood transfusions.
Phototherapy is treatment using a special light that helps the baby eliminate bilirubin. More feedings may also help the baby eliminate bilirubin.
The baby wears a diaper and eye coverings under fluorescent or quartz lamps. The bassinet may be lined with white linen or other reflecting material and white curtain surrounds the bassinet and phototherapy unit.
Monitoring for weight loss, output of urine and urine specific gravity are part of the process. The baby's fluid intake can be modified as needed.
Phototherapy is considered to be safe, and does not cause any problems long term.
In the most severe cases, blood exchange transfusions may be necessary. Phototherapy will usually be used first with transfusion as a last resort.
My grandbaby is spending time with the phototherapy lights. These lights are bringing down her bilirubin levels, so we are hoping that they will be all that's needed. But her parents are prepared for the possibility of blood exchange transfusions if the condition doesn't resolve as it should.
Is it nerve-wracking to be far away from my daughter and grandchild while they deal with this? You bet it is. But knowledge is reassuring. Knowing that they are in good hands who are providing the needed treatments for my family makes all the difference.
Sources:
Jaundice in Healthy Newborns. Kidshealth.org. Retrieved Sept. 16, 2014.
http://kidshealth.org/parent/pregnancy_center/newborn_care/jaundice.html
ABO Incompatibility in Newborns. Pregnancy.com.au. Retrieved Sept. 16, 2014.
http://www.pregnancy.com.au/resources/topics-of-interest/postnatal/abo-i...
Neonatal Jaundice Treatment & Management. Emedicine.medscape.com. Retrieved Sept. 16, 2014.
http://emedicine.medscape.com/article/974786-treatment
Visit Jody's website at http://www.ncubator.ca
Reviewed September 17, 2014
by Michele Blacksberg RN