Hi All,
>So, anyway, what I know is that Neil was at least two weeks old and still
>jaundice. Seems like he was yellow looking into three weeks. I was scared. I
>was worried that he might get sicker because the nurses telling me I was
>hurting him. He turned out fine.
I am not a medic, but I did have a child with severe pathologic jaundice
at birth, and I was able to breastfeeding exclusively nevertheless. The
following is our story, which was published in a local National
Childbirth Trust newsletter in 1996. Apologies to those of you who've
already seen it.
Alice, our second baby, was born at home on 11th September 1996 in a
very straight-forwards birth and was perfectly healthy but a little
sallow-looking. We thought perhaps it was just her natural skin tone and
no one really worried about it, but 5 days later, I woke up to discover
her literally *orange*. I still wasn't all that worried, but my midwife
sent us up to the hospital for a blood test "just in case".
When we got there took a sample of Alice's blood and the nurse came in,
looking white as a ghost.
"Take her up to the Special Care Baby Unit at the general hospital.
She has very bad jaundice and will need immediate treatment. It's
quicker if you take her yourself, but don't drive slowly". As you can
imagine, I was shocked. Alice, apart from her colour, seemed perfectly
well, and I couldn't believe she was actually ill. I always thought
jaundice was pretty common, if not normal, and never serious.
I drove to SCBU, still unconvinced that Alice was really ill. On arrival
at SCBU, Alice was immediately taken from me and loads of doctors buzzed
around her. I was deeply shocked when they showed me in about half an
hour later - she had drips in both arms and was lying on a sun-bed type
thing, with lamps above her and at the side of her. Her eyes were
bandaged and she had this plastic cloche thing over her body to keep her
warm. They wouldn't let me pick her up even for a second, let alone
breastfeed her. Yet, despite this, I still couldn't believe it wouldn't
all be over in a couple of hours.
Alice had to remain under the lights without a break for 8 hours, during
which time I had to relieve the increasing engorgement in my breasts by
hand expressing because the breastpump thing freaked me out. I was
terrified they'd give her formula, but they said they didn't treat
jaundice like that anymore because it wouldn't help her in the long run,
and they wanted me to breastfeed. Unfortunately, it was the day my milk
came in, so it couldn't have happened at a worse time. They told me
Alice would not be hungry, as she was being given glucose via the drips,
but to avoid using a dummy, I sat with my finger in her mouth for 2
hours. When I got tired, the nurses took over, sitting there with
fingers in her mouth in shifts to keep her happy.
Eventually, I was allowed to breastfeed Alice, but had to have most of
the lights pointing at us and I had to feed her with her eyes bandaged,
and just a nappy on my lap to catch any leaks, a fan heater blowing over
us to keep her warm. It was such a miserable breastfeeding experience, I
wanted to cry, but tried to be brave for Alice's sake.
The Pediatrician was absolutely brilliant. He was very knowledgeable
about breastfeeding and fully conversant with the problems of formula
feeding and allergies. He explained that this was not "breastmilk
jaundice" which many breastfed babies get, to no ill effect. He
described that type of jaundice as "a cosmetic problem only". Alice, he
said, had something called "haemolytic jaundice" or "ABO incompatibility
jaundice", which is a rare complication caused by my DH being A positive
blood group and me being O positive. He said nothing could have either
predicted or prevented it, and only a few babies born to parents of
different blood groups get the condition. It turned out that Alice's
levels of bilirubin (the yellow pigment) was 611 mmols/litre at its
worse, way above the danger level and off the charts. The reason I
couldn't breastfeed her for all that time was purely logistical - he
wanted her to breastfeed as much as possible, but for those few hours
she had to be under the lamps all the time (I suspect they assumed Alice
would take 45 minutes to nurse every 2 hours, not 5 minutes every 4
hours!).
Thankfully, Alice's levels of bilirubin fell dramatically and even
though I had already signed the consent form for an exchange blood
transfusion for her, she didn't need it. They said her being such a big
strong baby helped her. After the initial fall, the levels stayed pretty
much the same, but Alice was on the drip so didn't want to feed very
often. Gradually, they reduced the drip and then the lamps, and the
bilirubin levels stayed the same (but, she was doing more of the work
herself, without the drips and lamps). I was told to demand feed, and
numerous people came in to check Alice was actually feeding well.
Thankfully, they were very pleased - she fed 20 minutes in 4 hours at
first, and increased her feeds as the glucose was turned off.
After a couple of days, the lights were turned off, but we had to stay
in hospital until everyone was happy her bilirubin levels would not go
back up again. They didn't, and after a week, we went home again.
Since this happened in September, Alice's jaundice cleared up totally
within 6 weeks and no further action was taken.
--
Anna H. (Mummy to Emma, 17-1-95, Alice, 11-9-96, Samuel, 25-4-98)
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"I'm very courageous, but I have cowardly legs" Spike Milligan
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