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Jaundice – NewBorn Blood type incompatibility

ABO (blood group system) incompatibility is one of the diseases which can cause jaundice.

ABO incompatibility happens when a mother’s blood type is O, and her baby’s blood type is A or B. The mother’s immune system may react and make antibodies against her baby’s red blood cells. The consequences and treatment are similar to Rhesus disease.

Blood types are categorized by A, B, and O, and given an Rhesus (Rh) factor of positive or negative. A-B-0 and Rh incompatibility happens when a mother’s blood type conflicts with that of her newborn child. It is possible for a mother’s red blood cells to cross into the placenta or fetus during pregnancy. When this occurs, the mother’s blood cells develop antibodies that can attack the newborn’s blood cells and cause jaundice. The risk of this is highest near or during delivery.

A-B-O incompatibility occurs when:

the mother is type O and the baby is B, A, or AB

the mother is type A and their baby is B or AB

the mother is type B and their baby is A or AB

The first thing we must cover is what newborn jaundice is. Jaundice is when a baby has an increased level of bilirubin in her blood. Bilirubin is a yellow substance that the body creates when it replaces red blood cells and is filtered through the liver and removed from the body through stool. The increased level of bilirubin gives the baby’s skin and whites of her eyes a yellow tint; the tint will become more pronounced as the levels increase.

ABO incompatibility is one of the diseases which can cause jaundice.

ABO incompatibility happens when a mother’s blood type is O, and her baby’s blood type is A or B. The mother’s immune system may react and make antibodies against her baby’s red blood cells. The consequences and treatment are similar to Rhesus disease.

During pregnancy, problems can occur if you’re Rh negative and the baby you’re carrying is Rh positive. Usually, your blood doesn’t mix with your baby’s blood during pregnancy. However, a small amount of your baby’s blood could come in contact with your blood during delivery or if you experience bleeding or abdominal trauma during pregnancy. If you’re Rh negative and your baby is Rh positive, your body might produce proteins called Rh antibodies after exposure to the baby’s red blood cells.

The antibodies produced aren’t a problem during the first pregnancy. The concern is with your next pregnancy. If your next baby is Rh positive, these Rh antibodies can cross the placenta and damage the baby’s red blood cells. This could lead to life-threatening anemia, a condition in which red blood cells are destroyed faster than the baby’s body can replace them. Red blood cells are needed to carry oxygen throughout the body.

If you’re Rh negative, you might need to have another blood test — an antibody screen — during your first trimester, during week 28 of pregnancy and at delivery. The antibody screen is used to detect antibodies to Rh positive blood. If you haven’t started to produce Rh antibodies, you’ll likely need an injection of a blood product called Rh immune globulin. The immune globulin prevents your body from producing Rh antibodies during your pregnancy.

If your baby is born Rh negative, no additional treatment is needed. If your baby is born Rh positive, you’ll need another injection shortly after delivery.

If you’re Rh negative and your baby might be or is Rh positive, your health care provider might recommend an Rh immune globulin injection after situations in which your blood could come into contact with the baby’s blood, including:

Miscarriage

Abortion

Ectopic pregnancy — when a fertilized eggs implants somewhere outside the uterus, usually in a fallopian tube

Removal of a molar pregnancy — a noncancerous (benign) tumor that develops in the uterus

Amniocentesis — a prenatal test in which a sample of the fluid that surrounds and protects a baby in the uterus (amniotic fluid) is removed for testing or treatment

Chorionic villus sampling — a prenatal test in which a sample of the wispy projections that make up most of the placenta (chorionic villi) is removed for testing

Cordocentesis — a diagnostic prenatal test in which a sample of the baby’s blood is removed from the umbilical cord for testing

Bleeding during pregnancy

Abdominal trauma during pregnancy

The external manual rotation of a baby in a breech position — such as buttocks first — before labor

Delivery

If the antibody screen shows that you’re already producing antibodies, an injection of Rh immune globulin won’t help. Your baby will be carefully monitored. He or she might be given a blood transfusion through the umbilical cord during the pregnancy or immediately after delivery if necessary.

Results

If you’re Rh positive, no action is needed.

If you’re Rh negative and your baby is Rh positive, there’s a potential for your body to produce antibodies that could be harmful during a subsequent pregnancy. If you have vaginal bleeding at any time during pregnancy, contact your health care provider immediately. Also, talk with your health care provider about scheduling an Rh immune globulin injection during your pregnancy and remind your health care team of your Rh status during labor.

https://www.mayoclinic.org/tests-procedures/rh-factor/about/pac-20394960#:~:text=Rhesus%20(Rh)%20factor%20is%20an,the%20most%20common%20blood%20type.
https://www.cerebralpalsy.org/about-cerebral-palsy/risk-factors/blood-incompatibility#:~:text=When%20this%20occurs%2C%20the%20mother’s,is%20B%2C%20A%2C%20or%20AB
https://www.kidshealth.org.nz/abo-incompatibility

Jaundice by Blood Type Incompatibility Treatment Tips

When I was expecting Asher and Arnan, my second twin boys, I had planned on delivering by c-section However, they ended up coming early on my scheduled date, so we rush to the hospital and expecting to deliver as planned. But when we arrived at the hospital my water just totally broke so my OB was explaining that we might need to deliver the first baby in normal and the second by C-Section. As we are waiting for the Anesthesiologist to arrive, I already delivered my first baby Asher and after 5 mins my second baby Arnan was delivered.

After they were born, I was VERY tired, and I thought I pass out after giving birth to the 2. Looking back, I probably should have because my postpartum, but I did learn a few things in the process.

Around 24 hours after the twins was born, the newborn nurses screened their bilirubin levels. They did take blood sample from them and that wasn’t so easy, and it happened twice as the blood collected wasn’t enough for the test.

After the blood collection they sent her bloodwork to a lab, and then the twins and I went back and get some rest.

Baby (Not) Friendly Jaundice Treatment

Next, at an ungodly hour a nurse came into my room, flipped on the lights told me that

a) we needed to do phototherapy and

b) I also needed to start supplementing with formula

because the heel stick levels were high.

I told her we could start phototherapy and supplementing them with formula as my breastmilk can’t support 2 of them.

The nurses take my twin to NICU to do the phototherapy, they put protective eyewear on them, placed them in the bassinet and wheeled the light machine over. I was no longer able to hold my babies, except when breastfeeding. That was a nightmare.

The next morning a kind, intelligent nurse came in. At this point I was extremely confused on what was happening, and I thought it might be because I delivered them normally even though they need to be delivered by C-Section.

She quickly showed me the chart below and helped me to understand what was going on. The Twin’s bilirubin levels were indeed higher than they would like to see at the 24-hour mark, and they were more yellowish skin and eyes.

She talked to me like I was an intelligent human being. She answered my questions. She explained things and helped me to understand what conversations were likely coming my way.

Jaundice (also known as hyperbilirubinemia) is the cause of the yellow tinge that colors the skin and eyeballs of newborn infants, especially in the first week or two. Jaundice happens because babies are born with more red blood cells than they need. When the liver breaks down these excess cells it produces a yellow pigment called bilirubin. Because the newborn’s immature liver can’t dispose of bilirubin quickly, the excess yellow pigment is deposited in the eyeballs and skin of the newborn.

In our case, this kind of jaundice is due incompatibility of blood types between mother and baby, jaundice may be the result of problems that go beyond the normal breakdown of excess red blood cells. In rare instances, the bilirubin levels can rise high enough to damage baby’s brain. For this reason, if the healthcare provider suspects that something more than normal physiologic jaundice is the cause of baby’s yellow color, bilirubin levels will be monitored more closely, using blood samples. If the bilirubin level gets too high, your doctor may try to lower the bilirubin level using phototherapy, special lights which dissolve the extra bilirubin in the skin, allowing it to be excreted in the urine.

In some situations, such as physiologic jaundice, because it is part of a normal body process. Once the newborn’s bilirubin-disposal system matures and the excess red blood cells diminish, the jaundice subsides – usually within a week or two – and causes baby no harm. Jaundice is more common in premature infants, who are less able to cope with excess bilirubin.

After 3 days of staying in the hospital the doctor let me go home but my babies stayed in the for a couple more days. Every day, I visit the twins for 4 days in the NICU to still breastfeed them, the hospital is like 2-hour commute from our home. The struggle from not being with them and the tiredness I was felling due delivery was all paid off them the doctor let my babies go home and continue the treatment at home.

2 years later and the twins is already 2 years and 6 months they are taking a vitamin with vitamin d as it helps with jaundice years ago. As of now, my twins are super healthy and rarely catches cough and colds. I was very grateful for the nurses that helps us and for the vitamin D.

We are taking our kids outside every morning for best sunlight of the day. We always expose them to the sunlight and continue skin to skin.

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