Delayed Cord Clamping -- What's the difference between "jaundice requiring phototherapy" and "clinical jaundice"? - Mothering Forums
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#1 of 13 Old 04-24-2013, 11:04 AM - Thread Starter
 
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I've been reading this review of the major studies on delayed cord clamping: http://apps.who.int/rhl/reviews/CD004074sp.pdf

It says that delayed cord clamping (vs early clamping) resulted in a significant increase in the incidence of "jaundice requiring phototherapy," but no significant difference in "clinical jaundice." Does anyone know what the difference is between these two designations? I've Googled it, but I can't find any explanation.

Michelle, wife to DH, and momma to DD16, DS15, DS12, DS10, DD9, DD7, DS5, and baby girl born Christmas Eve 2013!
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#2 of 13 Old 04-24-2013, 12:13 PM
 
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Clinical jaundice is just jaundice in general. Jaundice over 20 usually requires photo therapy. It is still clinical jaundice.
 

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#3 of 13 Old 04-24-2013, 12:36 PM - Thread Starter
 
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So, that means there wasn't more jaundice in general, but more of the jaundice there was required phototherapy?

Michelle, wife to DH, and momma to DD16, DS15, DS12, DS10, DD9, DD7, DS5, and baby girl born Christmas Eve 2013!
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#4 of 13 Old 04-24-2013, 07:29 PM
 
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Yep. All babies have at least a little jaundice. Clinical jaundice is when it is high enough to present symptoms so say. Level 5 and under is normal. Then 5 to 19 is clinical where is presents symptoms. Lethargy, yellow skin and eyes. The 20 and up is phototherapy required due to the risk of brain damage from high bilirubin.

Billinrubin is cause by the death of red blood cells. When they die it increases. So when chord clamping is delayed more blood enters the baby. It is normal for blood cells to die in a newborn. I cannot remeber the exact science behind it right now. But more blood usually equals more billirubin and more jaundice in some babies. Especially babies born before 38 weeks. Somewhere between 38 and 42 weeks the mom gives babir a dose of vitamin d which combats it.
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#5 of 13 Old 05-15-2013, 02:30 PM
 
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There are caculations that have been gathered over time, historically during all this early cord clamping so that on hour 15 the bili should be this and at 27 hrs the bilirubin should be this number... Babies are put under lights at different levels of bili, depending on , gestational age, and hours after birth... 20 is not the magic number it once was.
In any case there is now a data base that has skewed numbers because of all the early clamping and we dont know what is clinically signifigant and what is normal for the delay in cord clamping babies. In addition there is doctor and nurse judgments that come into play. What that study ended up reporting was they put more babies under the lights but none were different as far as truly getting sick or damaged from bili.
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#6 of 13 Old 05-15-2013, 05:51 PM
 
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That is because brain damage from bilirubin happens around 24. They would not willing let a baby suffer such damage to make any kind of point which is why they are put under lights at 20. Believe me I had an infant in the NICU for 5 days for jaundice.

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#7 of 13 Old 05-15-2013, 06:12 PM
 
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Five days! How awful. I was told to nurse my son every two hours(from the beginning of each nursing session), in addition to a biliblanket, and he recovered much faster. Hopefully this information can help others.
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#8 of 13 Old 05-15-2013, 08:24 PM
 
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I nursed him every 1.5 hours for the entire 5 days.
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#9 of 13 Old 05-15-2013, 09:43 PM
 
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Here you can see what the range is, there is a tool I am trying to locate, they may have turned it into an app

http://www.medicalhealthtests.com/articles/337/general-articles/bilirubin-chart-for-newborn.html


My older hospital born children were kept in the hospital for different lengths of time because of ABO incompatability jaundice, my oldest who was term was kept under lights at day 3 with a bili level of 15, it never went over 15
My second at day 3 had a level of 22 that dropped to 19 and they released him from the hospital ...
My 2 home born babies had nothing above 7 , even though they had different blood type than me. The home born babies had long delayed cord clamping... Like 1/2 hr or so... The first 2 had the typical quick cut, maybe less blood made for a higher concentration of bili....IDK....
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#10 of 13 Old 05-15-2013, 11:01 PM
 
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What gestation were your babies born at?
 

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#11 of 13 Old 05-16-2013, 12:01 AM
 
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Were term , it mostly reflects to some degree the differing management styles and hosptial policies... My first was born in a smaller hosptial, the second at a big Kasier hospital in a city.


In any case when i just looked at my facebook page this article was in recently liked by a friend of mine. Covers the details about delayed clampng. No big harm to large increase in excess bili is what the studies are saying and they have their own speculation as to why


http://www.scienceandsensibility.org/?p=5730#.UZQDktmah_c.facebook
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#12 of 13 Old 05-16-2013, 12:06 AM
 
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Sorry tried to edit previous post but my ipad just isnt connecting right

Meant to say no increased damage due to increased blood volume, some early higher bili levels that seem elevated but they dont stay on the increase...
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#13 of 13 Old 05-26-2013, 10:50 PM
 
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That's an interesting point about the "benchmark" being skewed as being mostly based on early clamping. My MIL always frets about my babies' jaundice (from a distance, states away) and that's an interesting point that I can relay for this next birth :).  I totally get though that there certainly is an upper dangerous level.  Mine haven't been severe or even measured, just mild. But MIL still frets (retired RN). Anyway, this post is interesting to me.


Alicia, wife to an loving and faithful DH, and mama to three fantastic though nutty children (cs, then an HBAC, then a VBAC!!).
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