new baby jaundice - staying in hospital

[huskybo]

hello - my grandson was born last sunday and discharged the following day. On tuesday the midwife visited and said he had jaundice but it should clear up on its own,. babys mum told the midwife he was very sleepy and it was difficult to feed him - he didnt wake up for feeds, mum had to wake him and he falls asleep aftr a few gulps.

By tuesday evening he had hardly had any of his bottle and was still sleeping a lot. My son took him to the hospital - they did a heel prick and he still didnt wake up! A consultant said he would be ok to go home (this was at 1 am) but he needed a senior paedatrician to check this. An hour and a half later, the senior doctor checked baby and said , no keep him in for obs and put him on UV light.
He has been on that all day today. He has woken up for his feed a few times and cried when hes had heel pricks but the blood theyve taken from the heel pricks was minimal as none would come out. Thye sent the blood to be tested but have had to re do it because the first lot clotted. Hes also on a IV antibiotic drip as a precautionary measure.

I am a bit worried about this jaundice. i know a lot of babies get it but the midwife said he would be okay - the first consultant said he should be ok to go home but the senior doctor said the parents were right to bring baby in as the jaundice levels are high.
Is this normal?

[NanaNina]

Oh this takes me back 7 years to when my DGD was born in Dublin. The paediatrician had signed my dil and baby to be discharged and my son and their 4 year old were all there with the new car seat etc. Then a midwife happened to come by and said baby had to go to SCBU - wouldn't even let my dil finish the nappy change.

She was severely jaundiced and went under UV lights and the levels were high. Jaundice is caused by a chemical (bilirubin) in the blood and if the levels get very high they can be toxic, but ONLY if the baby isn't treated. The UV lights will start to bring down the levels. My DGD's levels were around 325-350 if I remember rightly and they didn't come down hardly at all for the first 2/3 days. I'm in the UK and couldn't get over there as I had a newly broken leg and was in plaster from thigh to ankle so I spent every hour clutching the phone, waiting for news.

To make matters worse it was a bank holiday and there were no consultant paediatricians about, although after one failing to notice baby was severely jaundiced it didn't give them much trust. On the 3rd or 4th day both my dil and son were in a state as the levels weren't coming down, and a Senior Midwife on SCBU got hold of them and said "look you daughter is going to be fine - I've seen this hundreds of time, and we don't know why the levels decrease rapidly in some babies and not in others, but it is by no means unusual" - I remember my son phoning me and that was a turning point really. And lo and behold the levels started coming down and once they started they came down fairly rapidly. I can't quite remember but I know she was discharged within a week. We never saw Bilirubin again (!) and she's now a healthy 6 year old but soon to be 7.

I think it's pretty shocking how the medics have been changing their mind but had it not been for that midwife noticing my DGD it might be a different story. I do worry about moms and babies being discharged so early, sometimes within hours of birth, mainly because of the worry about jaundice. In my day (I'm very old!) we were kept in hospital for 7 - 10 days! Babies were kept in the nursery at night and fed by the nurses. We got a great nights sleep - I remember vaguely hearing babies cry but since you didn't know whether it was yours or not, you just went back to sleep!

I'm sure your grandson will be fine.

[YokoUhOh]

Yes: normal. DS1 went under lights. DS2 also jaundiced but - due to previous experience - I kept feeding and feeding him and his levels stayed quite low.

The danger with jaundice is that in rare cases baby gets brain damage if too much bilirubin builds up. Frequent feeding flushes this out, and UV light breaks it down. Your DS has done the right thing - wishing her baby a speedy recovery.

[captainproton]

All my babies have had this. It's awful at the time, but something easily treatable. Early babies and rhesus negative mums can increase the chances of it developing.

[Justbeingnosey123]

it's very hard to tell jaundice levels by looking at a baby blood tests are really the only way to know so the midwife was using her judgement at the time all though as you describe your grandson I'm surprised she didn't send him to be checked. The consultant that asked for a second opinion I'm assuming was an a&e consultant, as there is nothing more senior, so was right to ask for a specialist opinion. The second doctor who sounds like a peadiatrician if this is uk based? Is the expert in things like this so sounds like the hospital followed the right protocol. They are doing the treatment I would expect from my experience in paediatrics and while I know it's very worrying for you as family I hope that reassures you a bit. Bloods clotting is a frequent problem as it's very difficult getting blood from babies but till they get the results from my experience the uv lights IV fluids and antibiotics will get on top of things. He already sounds like his waking up more which is a good sign

[NanaNina]

Interestingly they only found out about the cure for severe jaundice being UV lights, because when there were big wards, often with large windows, nurses noticed that the babies by the windows (I think it was a big bay window in the initial case) were less jaundiced than the ones not getting the light. I think it is quite common as others say, but in most cases it just clears up in a few days.

I think they must be able to tell just by looking if it's severe because the midwife who rushed my DGD to SCBU hadn't done a blood test (they were about to be discharged) so maybe in some cases it can be seen by an experienced midwife. I remember 50 years ago when my sister had had daughter (and first newborn I'd seen) I went home and cried to my mom that I thought my sister must have been with a Chinese man because the baby was bright yellow and had a shock of black hair! Sorry that wasn't meant to sound racist!

Let us know how baby goes OP

[Justbeingnosey123]

There's never a hard and fast rule rule on how a jaundice baby will look unfortunately. Colour can definitely be a indicator for experienced staff, also a sleepy baby that won't feed should be an indicator to do the blood test but I have seen yellow babies who don't need treatment and baby's who look fine but do so unfortunately it's only a guide. Experience definitely helps though. I do know a consultant who in the more mild cases would advice families to go home and lend time in a garden or near window with babies 😀

[BikeRunSki]

My DS was exactly the same OP. He felt better after a couple of days under UV lights, which helped him take more and more milk.

[eurochick]

I had a premmie. She was put in the incubator furthest from the window and sure enough developed jaundice. She needed a few spells under the lights as her levels wouldn't stay down but she got there eventually. It was hard because we could only hold her for 20 minutes a day when she was under the lights and she was visibly happier when being held.