AnnE-girl Posted November 21, 2015 Share Posted November 21, 2015 I had my sweet little boy early Wednesday morning after being induced at 39 weeks instead of going through a third round of testing for preeclampsia. I just wanted him out and safe instead of worrying about my BP anymore. He was a tiny 6lb6oz, my smallest baby by a full pound and DD was born a few days earlier then he was. My midwife sent my placenta to be tested because of weird blood vessels, so I'm not sure if there was an issue with his growth. My induction was long and he had some decels that were concerning, so I think that contributed to him being extra sleepy and not nursing well at first. We did ask to leave the hospital a day early because of a snowstorm coming. He was jaundiced in the hospital, but the pediatrician let us go as long as we followed up with our family practitioner yesterday to have him tested again. We live over an hour from the hospital where we delivered (I went back to my old midwife group from before we moved) so our regular doctor and hospital aren't connected to the one where we delivered. We went yesterday morning for the bilirubin testing and it was a nightmare of 20 minutes of a bs phlebotomist trying to get enough blood out of my poor baby's heel to do the test. Unfortunately his bilirubin levels went up to 14, after being 10 when we were released from the hospital, so the doctor wants us to come back to repeat the test this morning. I'm not sure what to do. I kind of feel like if we had another day to nurse now that my milk is coming in, and even giving a bottle or two to clear his system, we could avoid more trauma of blood draws, but I don't want to put him in danger if he does need the light therapy right away. My first two were didn't have any of these issues and I'm just sort at a loss to know the tight course of action. Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted November 21, 2015 Share Posted November 21, 2015 (edited) Could you call and ask whether nursing/putting down your baby next to a big window would have the same effect as light therapy? You might be able to reduce the number of blood draws by starting that straight away. My first was jaundiced after induction and a long labour, and this was what I was told to do. It was winter, so putting him outside wasn't an option. Best wishes L Edited November 21, 2015 by Laura Corin Quote Link to comment Share on other sites More sharing options...
Word Nerd Posted November 21, 2015 Share Posted November 21, 2015 I would follow the doctor's advice. I hated that my DD had to get poked so many times during and after her treatment for jaundice (she spent a night in NICU and had to be on a bili-bed at home), but it was over quickly and didn't bother her much. Sometimes she didn't even seem to notice. I think it's more traumatic for the mama than the baby. 1 Quote Link to comment Share on other sites More sharing options...
ktgrok Posted November 21, 2015 Share Posted November 21, 2015 I'd check, it's too serious not to. Doesn't mean you have to do lights, but you should know the numbers so you can make an educated decision. As for making the heal stick easier you can put a heating pad on his foot (even those instant kinds people put in their gloves/shoes) to warm the skin and get the blood moving. Also, hold him so that his foot is down, dangling, for several minutes beforehand, to get the blood pooling there. Hugs mama. 5 Quote Link to comment Share on other sites More sharing options...
Amira Posted November 21, 2015 Share Posted November 21, 2015 I think you should go with the rise in his bilirubin level. My third child wasn't "supposed" to be as jaundiced as he was, since I was breastfeeding and he was over 8 pounds when he was born, but he did need to spend a couple of days on a bili-bed. I know it is incredibly inconvenient to take him in, but you need to be sure that his bilirubin level is going down instead of up. I'm sorry. 1 Quote Link to comment Share on other sites More sharing options...
AnnE-girl Posted November 21, 2015 Author Share Posted November 21, 2015 Thanks for the thoughts, ladies. It's just hard to tell from some doctors if they are being cautious or too aggressive in their approach and I don't want to put my baby through more than he has to go through. Quote Link to comment Share on other sites More sharing options...
zoobie Posted November 21, 2015 Share Posted November 21, 2015 (edited) IIRC, levels peak between days 3-5. My 4th needed some time under the lights. There are also blankets that can go home with you. The baby won't remember the needle sticks. Do make sure they warm the heel and use ktgrok's other suggestions. :grouphug: Bunch of articles on breastfeeding jaundice. The levels are usually different than in formula fed babies. http://kellymom.com/health/baby-health/bfhelp-jaundice/ Edited November 21, 2015 by zoobie Quote Link to comment Share on other sites More sharing options...
DesertBlossom Posted November 21, 2015 Share Posted November 21, 2015 (edited) With my 2nd she had slightly elevated levels. They kept wanting me to come back "just to check." I think I took her in twice, watched the horrific blood-letting and never went back. I kept her in the sun and carefully watched her coloring and she was fine. Once my milk comes in I quit worrying about because I know that helps. If you're nursing you want to be careful introducing a bottle because every time the baby isn't nursimg on YOU, it's not signaling your body to make more milk. The more your baby is at your breast, the better your milm will come in. Edited November 21, 2015 by DesertBlossom Quote Link to comment Share on other sites More sharing options...
UCF612 Posted November 21, 2015 Share Posted November 21, 2015 My youngest was jaundiced, we had to stay 3-4 extra days in the hospital. He was my bigger baby (over 8lbs vs my 6lber) but they said it was due to us having different blood types I think. We did the lights plus formula. I was breastfeeding but we supplemented to get him moving. Definitely better to be safe than sorry. Quote Link to comment Share on other sites More sharing options...
Chris in VA Posted November 21, 2015 Share Posted November 21, 2015 Just wanted to send a :grouphug: . I know it's scary, and your protective Mama instincts are kicking in hard. That is a good thing! I would take him in and do what Katie said, and then follow all the recommendations. This too shall pass! :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
laundrycrisis Posted November 21, 2015 Share Posted November 21, 2015 I would go for the testing. Also we were able to avoid lights by waking him up to nurse every hour, even putting a little cold water on his head to get him going. Once the milk showed up, the jaundice went away. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2015 Share Posted November 21, 2015 take him to get tested. bili levels PEAK at 3 - 5 days, so he hasn't peaked yet. do whatever you can to get fluid in him because that will help flush his system. you can also strip him down, and let him lay in the sun coming in from a window. cover his eyes. dudeling's were 22 at 69hours. he was admitted to the hospital, on an IV and under FOUR different lights. they didn't release him until his levels had dropped to 12 and were falling. (he was a problem nurser, and I had to teach him how. nursing/feeding was a production until he was 8 weeks old. and he was still an ultra finicky eater.) the hospital we were at starts doing transfusions at 29. only afterwards did I find the death certificate for my grandfather's baby sister. she died at 3 days - and it was listed a newborn jaundice. before dudeling was diagnosed asd, he did children's studies at the local university. for one, he was disqualified because he had jaundice. it was also one of the things taken into consideration when he was officially diagnosed as asd. Quote Link to comment Share on other sites More sharing options...
Rachel Posted November 21, 2015 Share Posted November 21, 2015 My oldest did the billi blanket (light treatment) at home, it really was not a big deal. The heal sticks bothered me with him, but he healed quickly and they didn't bother him. I would have the testing done. 1 Quote Link to comment Share on other sites More sharing options...
Allearia Posted November 21, 2015 Share Posted November 21, 2015 I just wanted to mention that I had this with my second. For the first blood draw, the nurse sent us to the children's hospital, which was a nightmare. The next time, the pediatrician sent us back to the hospital I gave birth in for the blood draw, and it was so much better. Not fun by any means, but I was amazed at how much smoother and quicker it went. So it might be worth it to find out if there is a better place to get the blood drawn. My baby's bilirubin went quite high, but the doctor just told me to keep nursing around the clock as much as possible and we just missed having to go in for the light treatment. Just keep doing as much as you can. I know, the blood draw is the worst :( Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted November 21, 2015 Share Posted November 21, 2015 Bilirubin is excreted in the stool, so nursing often to have bowel movements will help bring the levels down. Breastmilk (and colostrum) has a greater laxative effect than formula so getting lots of breastmilk into the baby by frequent feedings can help excrete the bilirubin. If the baby is not pooping, then the bilirubin gets reabsorbed from the gut. Light therapy at home is preferable because it doesn't interfere with the breastfeeding relationship. They should be able to set you up with a bili-blanket at home rather than have to be on a light bed. Babies are happier when being held and may be easier to nurse. 3 Quote Link to comment Share on other sites More sharing options...
AK_Mom4 Posted November 21, 2015 Share Posted November 21, 2015 Congratulations on the new baby!!!!!! :hurray: :hurray: No advice on the jaundice. DS24 had it after he was born (rough birth at 36 weeks), but that was a hundred years ago and treatment has improved a bit since then. He has grown up just fine with no ill effects thanks to the treatment, though. Congratulations!!!!!! Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2015 Share Posted November 21, 2015 Bilirubin is excreted in the stool, so nursing often to have bowel movements will help bring the levels down. Breastmilk (and colostrum) has a greater laxative effect than formula so getting lots of breastmilk into the baby by frequent feedings can help excrete the bilirubin. If the baby is not pooping, then the bilirubin gets reabsorbed from the gut. Light therapy at home is preferable because it doesn't interfere with the breastfeeding relationship. They should be able to set you up with a bili-blanket at home rather than have to be on a light bed. Babies are happier when being held and may be easier to nurse. there are places that will rent lightbeds - but it really depends upon the bili level (and how they are repsonding) as to whether they can be treated at home, or need to be hospitalized. I had a cot in dudeling's cubby, and was able to stay with him almost the entire time. (six days). Quote Link to comment Share on other sites More sharing options...
AnnE-girl Posted November 21, 2015 Author Share Posted November 21, 2015 Thanks again, everyone! We did go in for the testing and the phlebotomist was so much better than yesterday. His levels did go up a little, but not enough to need light therapy yet. We're still waiting on a follow-up call from the doctor to go over the results more thoroughly, but I think it will just be to retest in a few days. DS is finally having more wet diapers so I think he's getting better at nursing. I've been second-guessing my decision to go ahead with the induction since it took so long (10pm Monday to 2am Wednesday) and he was so tiny when he came out, so having another thing that's potentially problematic is making me feel more guilty and worried, even though I know that it's not uncommon. Quote Link to comment Share on other sites More sharing options...
melmichigan Posted November 21, 2015 Share Posted November 21, 2015 (edited) :grouphug: I kept DD home back in the day before they developed the light bed that you could have at home. My milk didn't come in well and I breastfed with a Medela SNS system to supplement. We were told to nurse her every 3 hours around the clock regardless of what it took to wake her up. She eventually peaked at 20 and then improved. Another DD did spend time under lights in NICU, but her levels were much higher from premature delivery, and she was already hospitalized. Just keep nursing, and do keep any blood draw appointments. If you are willing to do the testing more peds are willing to let them be a home when possible. Congrats on your new baby! Edited November 21, 2015 by melmichigan 1 Quote Link to comment Share on other sites More sharing options...
amyx4 Posted November 21, 2015 Share Posted November 21, 2015 In addition to everything that's been listed above, I took my baby to a chiropractor that works with children. He adjusted the baby with a goal to help move along the stool. And boy did that work! Also, the phlebotomist used a warm compress before the heel stick. Good luck! 1 Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2015 Share Posted November 21, 2015 In addition to everything that's been listed above, I took my baby to a chiropractor that works with children. He adjusted the baby with a goal to help move along the stool. And boy did that work! Also, the phlebotomist used a warm compress before the heel stick. Good luck! I'm so sorry I didn't take dudeling into a chiro until he was four. I'd had one who loathed - and I *mean* loathed, ,forceps etc. he forbade his wife's ob from using them and demanded a c-section instead. dudeling had forceps and he had four cervical vertebra out of alignment. the chiro we see now has also adjusted a baby so it would poop properly - and the difference was huge. it also cut down on the baby's fussiness due to stomach pains. Quote Link to comment Share on other sites More sharing options...
Ellie Posted November 21, 2015 Share Posted November 21, 2015 I'm not a doctor, and I don't play one on TV, so this is not medical advice. But... Eighty percent of breastfed babies are jaundiced. The more you nurse (e.g., no formula, no water, no pacifiers, nurse around the clock as much as possible, including co-sleeping), the quicker your milk will come in, the quicker the jaundice will clear up. This can be tricky as jaundice often makes babies sleepy, but sometimes they will nurse in their sleep, which is where co-sleeping comes in. You need the rest anyway, right? :-) Again, I'm not a doctor, but you did ask on a non-medical forum, so there's that. :-) My second baby was jaundiced. We left the hospital after 24 hours, then I took her back the next day. She was visibly jaundiced, although not scary looking. :-) She was sleepy. The nurse practitioner looked at me and said, "You inspire confidence. In a couple of days if you think she's worse, bring her back. If not, don't." And I didn't. After a couple of days my milk came in, the jaundice cleared up, and baby woke up. Totally different baby, lol. 2 Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted November 21, 2015 Share Posted November 21, 2015 Glad to hear that the baby is doing well. Bilirubin level of 14 is not particularly high. Enough to watch it, especially in a baby born prior to 37 weeks, but not necessarily enough to need light therapy. Nursing often (like every 2 hours during the day and every 3 at night) will help move that stool along. Since babies born before 37 weeks have an immature liver, it takes longer to process the bilirubin out of the blood. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2015 Share Posted November 21, 2015 (edited) here is a link with a chart of bilirubin values (you'll need to scroll down.) http://www.medicalhealthtests.com/articles/337/general-articles/bilirubin-chart-for-newborn.html it should help you understand at what point you should be concenred, and why it needs to be monitered. you're probably still at a level where home treatment should be fine (assuming he responds) - but if the levels continue to climb, he may need to be hospitalized. hyperbilirueminia is nothing to mess around with. Edited November 21, 2015 by gardenmom5 Quote Link to comment Share on other sites More sharing options...
melmichigan Posted November 21, 2015 Share Posted November 21, 2015 before dudeling was diagnosed asd, he did children's studies at the local university. for one, he was disqualified because he had jaundice. it was also one of the things taken into consideration when he was officially diagnosed as asd. I haven't heard this before. My DD with asd was the one with the jaundice. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2015 Share Posted November 21, 2015 (edited) I haven't heard this before. My DD with asd was the one with the jaundice. when doing the phone interview for an asd study - when he was supposed to be in the control group - i was aksed if he had jaundice, and what his bili level was. I was then told he didn't qualify for the study. I've had converstations with other university students who were involved with developmental studies - and was told there is a link. I was then later told by the university child dev center who did his testing - that there is a link. I'm sure it depends upon what the bili level is. dudeling was at 22 and climbing fast when he was hospitalized at 69 hours and immediately put on an iv along with the lights. according to the peri there - they do blood transfusions at 29. according to one medical journal article I read - there is risk of permanent brain damage at 25. eta: once tx was started, he dropped below 20 fairly quickly, but was very slow to move into "safe" territory. Edited November 21, 2015 by gardenmom5 Quote Link to comment Share on other sites More sharing options...
Forget-Me-Not Posted November 22, 2015 Share Posted November 22, 2015 (edited) I had one with physiologic jaundice. She was yellow for 6-8 weeks and had to be put in the hospital for fluids/lights at one week. Her levels peaked around 21. So yeah, I would keep an eye on it. I know those heel pricks are awful. :( Congrats on your sweet new boy! Edited November 22, 2015 by Forget-me-not 1 Quote Link to comment Share on other sites More sharing options...
lollie010 Posted November 22, 2015 Share Posted November 22, 2015 Those were some of the scariest of my parenting moments. It seemed impossible to nurse a sleeping baby. My first three children were jaundiced but the third was by far the worst. Every conversation with the doctor made me so nervous, I think it was effecting my milk coming in. Hard times. I felt like the clock was ticking. But, I started eating raw garlic and waking baby up every two hours around the clock and things started turning around. My thoughts are with you. Keep us posted! Quote Link to comment Share on other sites More sharing options...
ktgrok Posted November 22, 2015 Share Posted November 22, 2015 I haven't heard this before. My DD with asd was the one with the jaundice. My child with ASD was also my most jaundiced, although he didn't require treatment. Quote Link to comment Share on other sites More sharing options...
Acadie Posted November 22, 2015 Share Posted November 22, 2015 A biliblanket at home is a minor hassle, nothing compared to a NICU stay. Our firstborn was in the NICU for several days with jaundice, and with our second we opted for a biliblanket at home on the early side to prevent the issues we'd had before. Jaundice here was due to ABO blood incompatibility and needed to be treated. Do you and babe have different blood types? Amy Quote Link to comment Share on other sites More sharing options...
J-rap Posted November 22, 2015 Share Posted November 22, 2015 Sorry, I don't know much about numbers, but I think with a newborn I wouldn't take any chances at all and would take him in. My firstborn was quite jaundiced (27 years ago!), and we kept him nude lying next to a sunny window! He recovered fine. Quote Link to comment Share on other sites More sharing options...
AnnE-girl Posted November 23, 2015 Author Share Posted November 23, 2015 Good update! We went for a third heel stick in four days today and his levels are going down (yesterday is the day they should have peaked) so, as long as he's acting normally, he should be fine and he doesn't need to be tested again. He's also up to within three ounces of his birth weight now that my milk has come in. He did get one ounce of formula Friday night when I was feeling panicky, but otherwise it's all been nursing. Thanks again for all the good thoughts! 5 Quote Link to comment Share on other sites More sharing options...
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