PSA: Did you know there is more to blood type than the ABO and Rh systems?

[Natalieclare]

ETA: This is especially important if you have had many babies (the symptoms increase in severity each pregnancy), if you are having a home-birth (sometimes follow-up can be spotty), and if you have had other jaundiced babies (can lull you in to thinking you can just ride it out).

 

For many of you this might be old hat, but I was shocked to learn one year ago yesterday that blood typing is much more complex that A/O/AB and Rh+/-.

 

One year ago today, my one day old baby boy was admitted to the children's hospital, ostensibly for a severe but routine case of jaundice. Within an hour of admitting into the children's hospital and placed under lights, it became apparent that his biliruben was still skyrocketing. It went all the way to 34. He was whisked to the ICU and placed under triple bank lights. As he was set up under the lights, a nurse ran me through the halls (literally ran me, I had to stop and ask her for a wheelchair--I'd just had a baby barely 24 hours before!) to draw blood so the "blood geeks" (an affectionate term, I gather) could see if there was something besides the ordinary breastmilk jaundice going on.

 

We found out that my baby PJ and I are both O+. But then we learned that we were incompatible in one the sub-types. I am little c- while he is little c +. I had no idea I even had a little c! Apparently, blood is also typed into C/c, D, and other subtypes. There may be more, but that is the extent of my knowledge. :tongue_smilie:So, his body responded just like a baby with Rh incompatibility would respond: hemolytic disease of the newborn. I gather that the repurcussions of little c incompatibility are second only to Rh in their severity. But there is no shot to give, no way of preventing a similar response in the next baby.

 

PJ was saved through receiving a double exchange transfusion and 2 rounds of IVIG (pooled antibodies from blood donors). Even 60 years ago, he would have died. We are so thankful that we were able to get him taken care of before he went into kernicterus, resulting in brain damage and hearing loss.

 

I guess I am writing this here because I had no idea that this was even possible. I want you all to know that this is possible. I mean, I had had 5 babies before with no problem whatsoever, other than what we thought was routine breastmilk jaundice. When I saw PJ turning orange, it didn't really stick out to me, since most of my other babies had been on the yellow side. But thankfully my husband, a pediatrician, noticed that he was turning too orange, too fast.

 

So please, if your baby looks jaundiced, especially if he is rapidly darkening, take action!

Edited March 20, 2011 by Natalieclare

[Natalieclare]

Here is PJ before we took him into the hospital.

[Melinda in VT]

Thanks for the PSA. My husband had a couple of blood transfusions as a newborn because of Rh incompatibility.

 

Glad your PJ is ok!

[Excelsior! Academy]

Yes, I knew, as I have a friend who lost two babies due to this. And my sis had major problems with an incombatability with her dh. It DOES get worse with each child.

 

I've never heard of this before. Why does it get worse? Does the momma's difference grow with each child?:bigear:

[Natalieclare]

Yes, I knew, as I have a friend who lost two babies due to this. And my sis had major problems with an incombatability with her dh. It DOES get worse with each child.

 

I'm so sorry to hear about your friend and sister. Before this happened in our lives, I think I thought just about everything was able to be taken care of with medicine. When I think about how close our shave was, I blanch.

[Natalieclare]

I've never heard of this before. Why does it get worse? Does the momma's difference grow with each child?:bigear:

 

 

I'll take a stab at answering and then have my dh check my answer when we get home from church.

 

I guess the antibodies increase with each pregnancy (if the baby is the opposite blood type) because the opposite type is recognized as foreign sooner. ??? There's my stab. Anyone is welcome to correct it!

 

I am feeling rather passionate about raising awareness about this. The incompatibility cannot be corrected, but if the symptoms are caught quickly enough, damage may be able to be averted. My first 4 babies were delivered in the hospital, but I was always sent home within 24 hours of delivery. It could have happened then. My next 2 were at home, but our midwife always trusted my husband to catch anything if anything were to go wrong. With our last 3 kids, we didn't do much in the way of newborn well child checks. If my husband's alarm bells hadn't started going off, I don't know if the PJ I now have, is the one I would have had. The what-ifs could go on forever, I know, but I'm so thankful everyone acted sosososo quickly. I want to empower others to be able to act quickly, too.

 

My antibody screens were all normal, so noone was on the look-out for this. I've never read about this in any What to Expect -type of book. Hence, my tiny WTM awareness campaign!

[Rebecca]

I tested postive for antibody E my last pregancy (number 6). My blood was drawn each month and thankfully, it resolved on its own and became negative.

 

It can become worse but it can also not happen. It all depends on the baby(s) in the womb.

 

Now I am carrying twins and my antibody was negative. It was just recommended I am tested again at 28 weeks to make sure I am still negative.

 

I never had a postive antibody before in any pregnancy and so far haven't since.

 

It was a scary time. If the titer would have gotten to a certain level- it required ultrasounds watching for anemia in the baby and possible in utero transfusions as well as early delivery.

 

I am so glad your little one is okay!

Rebecca

[Laurie]

That must have been so frightening! Thank goodness P.J. got the treatment he needed!

 

Happy Birthday, P.J.

:party:

[mommaduck]

As an Rh- mama, I appreciate the psa on this also :)

[Mona100]

I am a medical lab tech finishing my bachelor's degree in clinical technology which means I am a blood geek. Hehe. Never been called that before though. I work exclusively in the blood bank, 7on/7off. When a type and screen is performed, the ABO and Rh factor (which is a part of the Rh family of antibodies) is part of the type. The screen tests for at least 18 (or more) other antigens that are on the red cell. These antigens/ amtibody combos are the ones that can cause problems for transfusions and/or pregnancies. But in the OP's situation, I am shocked that you said your antibody screen was negative. I am trying to think of what situation where that could happen. Whenever we get a mom that has antibodies, the mom gets referred to UAB, the high risk maternity hospital in our area, so I don't get to see as many hemolytic disease of the newborn. It isn't as common anymore as it used to be because of the RhoGam shot which protects Rh negative moms. When a mom is Rh negative, they are really D negative. D is part of the Rh antibody family. In the OP's case, little c is part of the Rh antibody family.

 

But in the textbook case of hemolytic disease of the newborn, this is what happens. The mom is negative for the antigen (little c). Mom has a pregnancy with a baby who is positive for the antigen (little c). Mom develops antibodies for that antigen (little c). Mom gets pregnant again with a baby who has the antigen (little c). The antibodies of mom go out to destroy the red cells of baby.

 

If you have any more questions, I can hopefully answer them or at least have the book on my bookshelf to answer it.

[ereks mom]

As an Rh- mama, I appreciate the psa on this also :)

 

Me too!

[Lifelearnin']

I am so glad that your son is fine now. I also went through something similar to this with my children. My oldest was born and we had no complications. Next, my son was born. Within 24 hours he was so jaundice. His bilirubin was extremely high and he was immediately transfered to another hospital and given an exchange transfusion. That was definitely one of the scariest things I have been through. The doctors told us that it had to do with an ABO incompatibilty. My son did recover after some time in the NICU. My husband and I had decided to have another child a few years later. We were told by doctors that there is no way of knowing if this would be the outcome with the next child. Well, my youngest was born, and she also had a high bilirubin. Hers however, was not as high as my son's. She did need to spend a week in the hospital under the lights, but thankfully, she did not need anything else done. It really is frustrating to think that we really can't have anymore babies because I am convinced that we will go through something like this every single time. We really did take a risk having my youngest, but we were also unsure if there would be any problem. Now we know. I wish that something could be done to prevent this.

[newlifemom]

So I am even further in Mona100's world. When my 1st dd was born she had extremely low platelets, 17,000 iirc. This was due to an anitgen incompatibility. Thankfully she was a sectioned baby or . . . well we don't like to think about that.

 

I was amazed at the information I learned about her condition. [officially neonatalalloimmunethrombocytopenia]

 

You are right to send out your psa Natalie. I am so glad your son is well and you caught the problem. My heart goes out to those who do not.

[Unicorn.]

Bumping, because I think more people should see this. Thank you for sharing your story.

[12Stars]

Thank you for posting this. It is very valuable. I am pregnant right now with our 7th baby. We did have a miscarriage last year though, but we have 5 children and one on the way. I am O+ and so is my husband, we are not related in any way. So this is definitely something to think about and watch for.

[sewingmama]

Thanks for the warning. I'm an RH- mama but I got lucky because my DH is A- so all my babies have a -blood type. I did test positive to the antibodies with my second pregnancy but later tested negative and the DR said it was most likely the rhogam shot I had had at the time.

[Natalieclare]

I tested postive for antibody E my last pregancy (number 6). My blood was drawn each month and thankfully, it resolved on its own and became negative.

 

It can become worse but it can also not happen. It all depends on the baby(s) in the womb.

 

Now I am carrying twins and my antibody was negative. It was just recommended I am tested again at 28 weeks to make sure I am still negative.

 

I never had a postive antibody before in any pregnancy and so far haven't since.

 

It was a scary time. If the titer would have gotten to a certain level- it required ultrasounds watching for anemia in the baby and possible in utero transfusions as well as early delivery.

 

I am so glad your little one is okay!

Rebecca

 

Rebecca, I'm so glad your antibody was negative. I'm so glad your first baby was healthy. I'm so glad that you and your medical team are all over this. You will be in my prayers!

[Natalieclare]

I am a medical lab tech finishing my bachelor's degree in clinical technology which means I am a blood geek. Hehe. Never been called that before though. I work exclusively in the blood bank, 7on/7off. When a type and screen is performed, the ABO and Rh factor (which is a part of the Rh family of antibodies) is part of the type. The screen tests for at least 18 (or more) other antigens that are on the red cell. These antigens/ amtibody combos are the ones that can cause problems for transfusions and/or pregnancies. But in the OP's situation, I am shocked that you said your antibody screen was negative. I am trying to think of what situation where that could happen. Whenever we get a mom that has antibodies, the mom gets referred to UAB, the high risk maternity hospital in our area, so I don't get to see as many hemolytic disease of the newborn. It isn't as common anymore as it used to be because of the RhoGam shot which protects Rh negative moms. When a mom is Rh negative, they are really D negative. D is part of the Rh antibody family. In the OP's case, little c is part of the Rh antibody family.

 

But in the textbook case of hemolytic disease of the newborn, this is what happens. The mom is negative for the antigen (little c). Mom has a pregnancy with a baby who is positive for the antigen (little c). Mom develops antibodies for that antigen (little c). Mom gets pregnant again with a baby who has the antigen (little c). The antibodies of mom go out to destroy the red cells of baby.

 

If you have any more questions, I can hopefully answer them or at least have the book on my bookshelf to answer it.

 

Thank you for replying to this thread with your expertise. I feel like all I am really providing with my "medical" explanations are basically cave drawings. :tongue_smilie: Not my field. And thank you for being a "blood geek"! ;) You don't know how many times I blessed you and all your professional cohorts as I sat next to PJ's isolette.

 

What is assumed to have happened in my case is that I developed antigens in my last pregnancy, just not very many, not enough to be measurable. The largest quantity of antibodies are acquired at the last stages of pregnancy. Looks like I just didn't develop a large enough amount to be measured until after that 28 week antibody test.

 

Doncha wanna develop a Rhogam type shot for us little c neg types??? Or are you saying that little c - would be helped by RhoGam? My understanding was that it wouldn't.

[EthiopianFood]

Okay, so + and - blood type of the mother has nothing to do with this, right? And the doctor can or can not test for all these different subtypes during pregnancy?

 

ETA: Okay, I see above that they do test for this. I guess what I'm wondering is, does me being O+ still make me at risk for this thing?

Edited March 21, 2011 by RaeAnne

[Natalieclare]

So I am even further in Mona100's world. When my 1st dd was born she had extremely low platelets, 17,000 iirc. This was due to an anitgen incompatibility. Thankfully she was a sectioned baby or . . . well we don't like to think about that.

 

I was amazed at the information I learned about her condition. [officially neonatalalloimmunethrombocytopenia]

 

You are right to send out your psa Natalie. I am so glad your son is well and you caught the problem. My heart goes out to those who do not.

 

I rejoice with you, Pam, and your dd, and I grieve for those who have lost children. <weepy sigh>

[Natalieclare]

Yay- I learned to multiquote!

 

Thank you for posting this. It is very valuable. I am pregnant right now with our 7th baby. We did have a miscarriage last year though, but we have 5 children and one on the way. I am O+ and so is my husband, we are not related in any way. So this is definitely something to think about and watch for.

 

Yes, keep it on your radar. Be sure to get all the usual antibody tests, but even if they all look normal, watch for rapid onset jaundice.

 

Thanks for the warning. I'm an RH- mama but I got lucky because my DH is A- so all my babies have a -blood type. I did test positive to the antibodies with my second pregnancy but later tested negative and the DR said it was most likely the rhogam shot I had had at the time.

 

Whew!

 

Okay, so + and - blood type of the mother has nothing to do with this, right? And the doctor can or can not test for all these different subtypes during pregnancy?

 

ETA: Okay, I see above that they do test for this. I guess what I'm wondering is, does me being O+ still make me at risk for this thing?

 

I hope Mona100 will chime in here...but yes, this could still happen to you. I am O+, my baby is O+. For us, I developed an antigen (am I saying that right? My medical brain is in the bedroom, snoring) to little c + toward the end of my 6th pregnancy. All my previous blood tests were normal. That's why I want to let moms know to take jaundice really seriously. In this case jaundice is the symptom that the antibodies are attacking the blood cells.

[Ibbygirl]

Oh my gosh how scary! I didn't know this. I'm RH negative so I knew about that type of incompatibility, but this one is completely new to me. I'm so glad that your little PJ recovered. Thank you for the PSA.

[EthiopianFood]

I hope Mona100 will chime in here...but yes, this could still happen to you. I am O+, my baby is O+. For us, I developed an antigen (am I saying that right? My medical brain is in the bedroom, snoring) to little c + toward the end of my 6th pregnancy. All my previous blood tests were normal. That's why I want to let moms know to take jaundice really seriously. In this case jaundice is the symptom that the antibodies are attacking the blood cells.

 

I'm so sick of all the things I need to worry about, all the things that can go wrong. :(

 

I wonder how late this thing can show up? I mean, if I get tested at 38 weeks, will it show up if it is to be an issue, or is there still a chance something will develop later?

[d.g.]

I didn't know the specifics for a long time, but my youngest uncle (baby #5) almost died from an incompatability. He ended up with several transfusions as a newborn and was still touch-and-go for a while. I grew up hearing the stories, so I always knew there was a risk.

 

When I was in late high school and early college, I was a regular blood donor. Since I'm O-, I felt a bit of an obligation, ya know? Well, once I had a "blood geek" tell me that they really appreciated getting my donation...I apparently was negative for so many different things that they could give my blood to just about anyone, including itty bitty babies. Which, of course, also meant that I was at higher risk for incompatability with my own babies since I had more things to develop antibodies to...

 

I'm done with pregnancy, and I had a tubal ligation during my 2nd c-section. Even with that, I still had to refuse the Rhogam shot 6 TIMES the first day after the surgery, and sign who knows how many refusal forms. These issues are that serious.

 

Thanks for the PSA.

[JeneralMom]

When you are given a blood test and told you are O- (for example) it tells you two things - that your phenotype is O- but that your genotype (what your actual alleles are) is OO and D-D-. The negative in your phentoype refers only to the D antigen of the Rhesus system - if you are D- it means you do not have any D antigen and the nomenclature is to write it as "d". There are also C, c, E, and e antigens on the Rhesus system. So, technically your genotype could look crazy combo of DdCcEe and + and -.

 

For your body to produce antibodies against an antigen it must be exposed to that antibody. When we teach basic genetics we are often asked why 1st time moms need to get Rhogam shots and have to explain that many women have miscarriages that they do not know about and even that can produce some blood transfer between mom and child. It also explains why things like this can show up in later pregnancies and increase in severity.

 

I am very glad that your little one got the help he needed!!

 

Not to freak anyone out, but there is also ABO incompatibility as well.

[fairfarmhand]

I've wondered if this was the reason that some mothers 150 years ago would lose baby after baby....

 

I know an elderly lady who lost several babies because of RH stuff...this was probably 60 years ago and there wasn't anything they could do.

[Mona100]

I am going to try to quote but I don't think it is going to work.

 

 

"Doncha wanna develop a Rhogam type shot for us little c neg types??? Or are you saying that little c - would be helped by RhoGam? My understanding was that it wouldn't."

 

The reason why there is not a similar "Rhogam" shot for each of the Rh antibodies is due to the low incidence rate for this type of incompatibility to happen usually. And you are right, RhoGam is only for the Rh negative woman. At my hospital, women go thru the ob clinic and have 1 type and screen performed at the 1st trimester. Then if they are Rh negative, they have another type and screen performed around the time they get the RhoGam shot during the 28-30 week mark of the pregnancy. Then when you are admitted to the hospital for labor, you get another type and screen performed. That is when your screen should have been positive. I guess what my confusions was why is wasn't picked up then but I think I went back and read that is was a home birth right? But you are right, it does get stronger during the pregnancy due to your body making the antibody against the baby's antigen.

[Mona100]

Okay, so + and - blood type of the mother has nothing to do with this, right? And the doctor can or can not test for all these different subtypes during pregnancy?

 

ETA: Okay, I see above that they do test for this. I guess what I'm wondering is, does me being O+ still make me at risk for this thing?

 

Yes, it does but I don't think it is something to lose sleep over. Genetics is an amazing thing. Conditions have to be perfect or imperfect, depending on the way you look at it, for something like this to happen. Believe me, jaundice in a baby is taken very seriously. In fact, I had to deal with that myself due to an ABO incompatability. My daughter is A+ and I am O- so she had to sit under the lights for a couple of hours. This type of incompatiblity is very very common.

[Mona100]

I'm so sick of all the things I need to worry about, all the things that can go wrong. :(

 

I wonder how late this thing can show up? I mean, if I get tested at 38 weeks, will it show up if it is to be an issue, or is there still a chance something will develop later?

 

If you are having your baby at the hospital, it will definitely show up there bc they will do another type and screen on you.

[Mona100]

When I was in late high school and early college, I was a regular blood donor. Since I'm O-, I felt a bit of an obligation, ya know? Well, once I had a "blood geek" tell me that they really appreciated getting my donation...I apparently was negative for so many different things that they could give my blood to just about anyone, including itty bitty babies. Which, of course, also meant that I was at higher risk for incompatability with my own babies since I had more things to develop antibodies to...

 

I'm done with pregnancy, and I had a tubal ligation during my 2nd c-section. Even with that, I still had to refuse the Rhogam shot 6 TIMES the first day after the surgery, and sign who knows how many refusal forms. These issues are that serious.

 

Thanks for the PSA.

 

 

For you to be able to give blood for babies, you must have been CMV negative. CMV is cytomegalovirus which is just a cold type virus but for premature babies it can cause brain damage if they are exposed to it. I bet your phone was ringing off the hook for you to donate whenever it was possible for you to donate.

 

The reason you had to sign a bunch of papers to refuse the RhoGam was due to legal reasons. If you didn't get the RhoGam and you didn't sign and if you got pregnant again, you could lose the fetus and any other subsequent fetuses. That is lawsuit city and you would definitely get money from that hospital. Whenever we have a woman come through the ER who is Rh negative and they let the mom go home, if she is having a miscarriage, we have a fit up in the blood bank because we know the mom should get the RhoGam shot. We have had the ER track them down and bring them back in or they have to go to their doctor and get that shot. They have 72 hours to get that shot. It is a serious thing which can be prevented nowadays.

[TKDmom]

Thank you for the PSA! I'm glad all is well again.

 

There is a lady at my church who had (I think) 7 babies with Rh diseaase (as she called it). 5 of them died. A few weeks ago, she told us the story of losing her last daughter. She was very angry that God would allow this to happen to her.

 

She said that her antibody titer was so high that the folks at Johnson & Johnson came by asking her permission to draw blood. They were developing the RhoGam shot and needed a live donor. They told her that her antibodies were what helped them to finish developing the RhoGam shot.

 

I've had that shot 9 times, and all my children have been healthy, despite the fact that they are all A+, and I'm O-. I'm so grateful to women like her who have enabled me to have healthy children. Modern medicine is really an amazing blessing.

[EthiopianFood]

If you are having your baby at the hospital, it will definitely show up there bc they will do another type and screen on you.

 

 

What specifically do I ask for to make sure this is done? I have been is way too many situations where the doctor/midwife/whomever SHOULD have known what was going on, and instead, *I* was the one who had to insist on something necessarily.

 

So there is a shot that is different than the Rhogam shot for this issue? If I am pregnant, and antibodies develop, I am assuming the shot won't help with that baby, only the next?

 

The thing is, mild jaundice is NOT a big deal, no matter what the hospital says, so I would have to decide for myself if it had become severe. I just don't want to be in this position. Sitting a baby in the sun can take care of jaundice. I have no interest in making my child stay in the hospital for 24 hours under lights "just in case" over the remote possibility that they have a serious condition that could have been recognized BEFORE the child was born.

Edited March 22, 2011 by RaeAnne

[Mona100]

What specifically do I ask for to make sure this is done? I have been is way too many situations where the doctor/midwife/whomever SHOULD have known what was going on, and instead, *I* was the one who had to insist on something necessarily.

 

So there is a shot that is different than the Rhogam shot for this issue? If I am pregnant, and antibodies develop, I am assuming the shot won't help with that baby, only the next?

 

The thing is, mild jaundice is NOT a big deal, no matter what the hospital says, so I would have to decide for myself if it had become severe. I just don't want to be in this position. Sitting a baby in the sun can take care of jaundice. I have no interest in making my child stay in the hospital for 24 hours under lights "just in case" over the remote possibility that they have a serious condition that could have been recognized BEFORE the child was born.

 

I have never seen a momma in the hospital not have a type and screen; no matter how quick the baby comes. When you are admitted and they are drawing blood for labs, just ask if a type and screen is one of the tests. It should be.

 

There is no shot for any other antibodies just RhoGam for Rh negative mothers.

 

Personally, I wouldn't mind a baby being watched for jaundice and put under the lights for extra time. Why put yourself in that position of making the decision of how jaundice is too jaundiced anyway? There is a lab test for that; a total bilirubin. The results of that test determine whether or not a baby gets put under the lights anyway. I can understand your stance though in not wanting the baby to have extra days in the hospital. When I had my daughter, she had an ABO incompatability which is fairly common. She was put under the lights for a couple of hours and was fine. I only had to wait a couple of hours after my discharge for her to be discharged.

 

I know there is alot to be worried about during pregnancy but I don't think this should be at the top of your list.

Edited March 22, 2011 by Mona100
misspelling

[EthiopianFood]

I have never seen a momma in the hospital not have a type and screen; no matter how quick the baby comes. When you are admitted and they are drawing blood for labs, just ask if a type and screen is one of the tests. It should be.

 

There is no shot for any other antibodies just RhoGam for Rh negative mothers.

 

Personally, I wouldn't mind a baby being watched for jaundice and put under the lights for extra time. Why put yourself in that position of making the decision of how jaundice is too jaundiced anyway? There is a lab test for that; a total bilirubin. The results of that test determine whether or not a baby gets put under the lights anyway. I can understand your stance though in not wanting the baby to have extra days in the hospital. When I had my daughter, she had an ABO incompatability which is fairly common. She was put under the lights for a couple of hours and was fine. I only had to wait a couple of hours after my discharge for her to be discharged.

 

I know there is alot to be worried about during pregnancy but I don't think this should be at the top of your list.

 

My baby almost died after she was born because of severe meconium aspiration. She had to be transfered to a children's hospital, despite our hospital having a good NICU. She didn't come home for almost a week, and the first day, we didn't know if she would survive. They had just done a nonstress test that morning, and she had been fine. :001_huh: I tend to worry about the unexpected now.

 

OP, I'm sorry for the hijack. I'm so, so glad your baby is fine. I really appreciate the PSA. :grouphug:

[Natalieclare]

What specifically do I ask for to make sure this is done? I have been is way too many situations where the doctor/midwife/whomever SHOULD have known what was going on, and instead, *I* was the one who had to insist on something necessarily. This is precisely why I wanted to let people know this condition existed.

 

So there is a shot that is different than the Rhogam shot for this issue? If I am pregnant, and antibodies develop, I am assuming the shot won't help with that baby, only the next? I think Mona answered this, but no, there is no shot for c-, no preventative measures. The thing that helps a baby when the antibodies are strong enough is getting new blood into the baby, blood that doesn't have antibodies that attack the baby's own blood. Actually, I guess there are some cases where lights are enough, but for my baby his body was overwhelmed.

 

The thing is, mild jaundice is NOT a big deal, no matter what the hospital says, so I would have to decide for myself if it had become severe. I just don't want to be in this position. Sitting a baby in the sun can take care of jaundice. I have no interest in making my child stay in the hospital for 24 hours under lights "just in case" over the remote possibility that they have a serious condition that could have been recognized BEFORE the child was born.

RaeAnne, with my 20/20 hindsight vision, I can see that there should have been NO question about getting his jaundice checked. Did you see the picture in the second post? He really was as orange as his brother's shirt...it just didn't stick out to me at the time. I was tired; I have orange curtains, and orange pajamas for me, and orange pajamas for my other son. There's a LOT of orange in my house! I think it contributed to me not paying close enough attention.

 

That picture was from the night before we took him to the hospital (he was about 10 hours old), so you can imagine that he was even "oranger" the next day. Sitting in the sun would have done nothing for this baby. A little sunshine could never have broken down all the biliruben that resulted from his exploded blood cells.He needed new blood.

 

If you are having your baby in the hospital, your blood will most likely be checked. If your pediatrician comes to check on you before the baby is 24 hours old (policy at my dh's practice), s/he will show all the proper concern about jaundice. If you take your baby into your first newborn baby appointment, there is another check. The point is, that we didn't have these checks in place. We got complacent and sloppy.

My baby almost died after she was born because of severe meconium aspiration. She had to be transfered to a children's hospital, despite our hospital having a good NICU. She didn't come home for almost a week, and the first day, we didn't know if she would survive. They had just done a nonstress test that morning, and she had been fine. :001_huh: I tend to worry about the unexpected now.

 

OP, I'm sorry for the hijack. I'm so, so glad your baby is fine. I really appreciate the PSA. :grouphug:

 

:grouphug::grouphug: back to you! I'm so sorry you had a rough go of it with your baby. I feel all akin, now, to anyone who has gone through something like that, and I can certainly see how it increases the worries. :grouphug::grouphug:

 

And aack! RaeAnee, I didn't mean to worry anyone. I really wanted just to raise awareness about a rare, strange, rare occurance. Did I mention it was rare? This is not something that is going to strike just anyone. It's all about genetics. (Which is not my forte.)

[Mona100]

My baby almost died after she was born because of severe meconium aspiration. She had to be transfered to a children's hospital, despite our hospital having a good NICU. She didn't come home for almost a week, and the first day, we didn't know if she would survive. They had just done a nonstress test that morning, and she had been fine. :001_huh: I tend to worry about the unexpected now.

 

OP, I'm sorry for the hijack. I'm so, so glad your baby is fine. I really appreciate the PSA. :grouphug:

 

 

Oh my, no wonder you are stressed. I hope everything turned out ok. I know when I was pregnant, my neighbor who was also pregnant had the same thing happen to her. Lots of issues. So, I was freaked out about that too. But Natalie is right, it is a rare thing. All the stars have to be aligned in the sky.

[TravelingChris]

Mona100- I hsve some questions about my daughter and her future pregnsncies. My older dd has AB- blood and also has Factor V Leiden. So I am understanding she will need Rhogam if her husband is positive and at least close monitoring because of the greatly increased blood clotting risk. Anything because of the AB blood? Anything else? (SHe is 17.5, not pregnant, not married but who knows in 5 years?)

[herbalgirl]

Thank you for this info. Wow, I had never heard of this before. I am pregnant for the 7th time, but this will be my 6th baby. I just had a m/c before getting pg this time. I am also O+. Dh is O-. All of my other babies have been slightly jaundiced, and a few have had to be under the lights while in hospital, but nothing really serious. I can't remember the blood types of my babies, though...

 

I am planning on a homebirth with this one, too, so I will be extra vigilant and be sure to bring him in if I see him getting very orange.

Edited March 22, 2011 by herbalgirl
Added dh's blood type.

[Veritaserum]

I am O+ and my dh is A-. We've had five babies. Only the first one had jaundice and it didn't turn out to need treatment (had her bili levels checked). We are thinking about baby #6. Can I request this screen before we TTC?

[d.g.]

For you to be able to give blood for babies, you must have been CMV negative. CMV is cytomegalovirus which is just a cold type virus but for premature babies it can cause brain damage if they are exposed to it. I bet your phone was ringing off the hook for you to donate whenever it was possible for you to donate.

 

The reason you had to sign a bunch of papers to refuse the RhoGam was due to legal reasons. If you didn't get the RhoGam and you didn't sign and if you got pregnant again, you could lose the fetus and any other subsequent fetuses. That is lawsuit city and you would definitely get money from that hospital. Whenever we have a woman come through the ER who is Rh negative and they let the mom go home, if she is having a miscarriage, we have a fit up in the blood bank because we know the mom should get the RhoGam shot. We have had the ER track them down and bring them back in or they have to go to their doctor and get that shot. They have 72 hours to get that shot. It is a serious thing which can be prevented nowadays.

 

Yup, they called and sent me reminder mail all the time. Heck, at one point I was getting Christmas cards! I don't donate right now because I'm still nursing my toddler and have enough demands on my system, but once he's weaned, I'll probably get back on a regular schedule.

 

I was aware of the personal AND the legal/liability repercussions when I refused the Rhogam, but really. I had to refuse verbally several times, then again when they brought the syringe into my room after I'd already refused. Then I had to wait while they went and asked permission to LET me refuse it. Then papers. Then another verbal refusal. Then later, more papers for some reason.

 

I wasn't being irresponsible, and I was aware of the risks of not getting the shot, but didn't see how any of that applied to me. I'd just had surgical sterilization. I didn't need/want it, and had to fight far too hard against it. I'm still a bit angry that I had to put so much energy immediately post-partum into protecting myself from the good intentions of my care providers instead of bonding with my new babe.

 

 

transientChris -- Even if your daughter's husband is Rh-, she might still get the shot as a routine part of prenatal care. With my first, I was told it's "just in case the father is +", even if my DH was tested and came up negative. They were quite careful not to say it, but as far as I know they have to assume there's always the possibility it's not your husband's baby, even if you're certain... :glare:

[Mona100]

I am O+ and my dh is A-. We've had five babies. Only the first one had jaundice and it didn't turn out to need treatment (had her bili levels checked). We are thinking about baby #6. Can I request this screen before we TTC?

 

ok, I have a dumb question. What does TTC stand for?

 

If you are pregnant, you should be getting labs drawn in one of the first dr. visits. One of the tests should be a type and screen. Just ask when they draw your blood. For me, anytime I have blood drawn I always ask exactly what they are drawing for.

[Mona100]

Mona100- I hsve some questions about my daughter and her future pregnsncies. My older dd has AB- blood and also has Factor V Leiden. So I am understanding she will need Rhogam if her husband is positive and at least close monitoring because of the greatly increased blood clotting risk. Anything because of the AB blood? Anything else? (SHe is 17.5, not pregnant, not married but who knows in 5 years?)

 

Can't answer any questions about the Factor V Leiden, but she will get the RhoGam during her pregnancy around the 28th week as a precaution regardless of what the daddy's blood type. After she has the baby, the baby's blood type is tested and depending on the Rh factor of baby determines whether or not she will get another RhoGam shot after delivery. If baby is Rh positive, she will get the RhoGam; If baby if Rh negative, she will not have to have RhoGam.

[Mona100]

Yup, they called and sent me reminder mail all the time. Heck, at one point I was getting Christmas cards! I don't donate right now because I'm still nursing my toddler and have enough demands on my system, but once he's weaned, I'll probably get back on a regular schedule.

 

You are an angel sent from Heaven. Keep up the good work!

[milovany]

ok, I have a dumb question. What does TTC stand for?

 

 

Try(ing) to conceive.

[mommaduck]

For you to be able to give blood for babies, you must have been CMV negative. CMV is cytomegalovirus which is just a cold type virus but for premature babies it can cause brain damage if they are exposed to it. I bet your phone was ringing off the hook for you to donate whenever it was possible for you to donate.

 

The reason you had to sign a bunch of papers to refuse the RhoGam was due to legal reasons. If you didn't get the RhoGam and you didn't sign and if you got pregnant again, you could lose the fetus and any other subsequent fetuses. That is lawsuit city and you would definitely get money from that hospital. Whenever we have a woman come through the ER who is Rh negative and they let the mom go home, if she is having a miscarriage, we have a fit up in the blood bank because we know the mom should get the RhoGam shot. We have had the ER track them down and bring them back in or they have to go to their doctor and get that shot. They have 72 hours to get that shot. It is a serious thing which can be prevented nowadays.

You know, I had no idea that I needed a Rhogam with a miscarriage. I miscarried Dec before this past one and never went in to be seen. I miscarried again in July, went in only because I wanted to be seen and was planning on sterilisation. Found out I was pregnant and needed a Rhogam because of the miscarriage...and each time I bled during the pregnancy, I was given another shot of Rhogam.

[*Jessica*]

TTC = trying to conceive

 

Natalieclare, thank you for the PSA! I find this stuff pretty hard to understand, but I'm going to try to do some reading up on it.

 

I am O- and have had two A+ sons. Both of my boys tested Coombs positive. My eldest was severly jaundiced and spent 5 days in the hospital under lights. My second was a summer baby and sunshine and time took care of his jaundice. I'm currently 19 weeks pregnant with baby #3. My antibody screens were normal, but I'll be sure to keep a very close eye on the little one.

[KellyGirl]

Thanks for the PSA, I find this stuff very interesting to read about. I have an incompatibility issue with the antigen Kell - haven't seen that one mentioned yet, but it was caught in the initial screen with baby #2 and I have been monitored carefully (through sonograms) with every pregnancy since then. It's one of those rare ones so there isn't a shot for it like there is for Rh-. Thankfully all my babies have been healthy (so far - number 5 is in the oven now).

[EthiopianFood]

I was tired; I have orange curtains, and orange pajamas for me, and orange pajamas for my other son. There's a LOT of orange in my house!

 

:lol:

 

 

That picture was from the night before we took him to the hospital (he was about 10 hours old), so you can imagine that he was even "oranger" the next day. Sitting in the sun would have done nothing for this baby. A little sunshine could never have broken down all the biliruben that resulted from his exploded blood cells.He needed new blood.

 

If you are having your baby in the hospital, your blood will most likely be checked. If your pediatrician comes to check on you before the baby is 24 hours old (policy at my dh's practice), s/he will show all the proper concern about jaundice. If you take your baby into your first newborn baby appointment, there is another check. The point is, that we didn't have these checks in place. We got complacent and sloppy.

 

I know what you're saying. I just don't always trust what doctors say, so I like understanding potential complications as well as possible so I can make informed decisions. If I hadn't ended up with a traumatic birth, I would probably be the homebirth type! LOL Doctors push for all sorts of things that aren't even necessary, often because of liability issues, you know? :glare: But no, you weren't complacent and sloppy. You were human, with a newborn. 'Nough said. :001_huh: :tongue_smilie:

 

And aack! RaeAnee, I didn't mean to worry anyone. I really wanted just to raise awareness about a rare, strange, rare occurance. Did I mention it was rare? This is not something that is going to strike just anyone. It's all about genetics. (Which is not my forte.)

 

You could have saved a baby's life. Don't apologize. :001_smile:

 

Oh my, no wonder you are stressed. I hope everything turned out ok. I know when I was pregnant, my neighbor who was also pregnant had the same thing happen to her. Lots of issues. So, I was freaked out about that too. But Natalie is right, it is a rare thing. All the stars have to be aligned in the sky.

 

She's fine now. Her sitution was rare as well, that it would be that severe. I'm just so aware of the fact that the worst case scenario happens to a real person, not a "statistic." It really could be you. Thats life. Having a plan, understanding the details, helps me feel like I have one more thing that I can fix/prevent, so in the end, it's a good thing.