Coombs Positive - Mothering Forums
Life With a Baby > Coombs Positive
ellymay's Avatar ellymay 03:19 PM 05-18-2006
Has anyone ever had thier newborn be coombs postitive? Briana is and I think
ds was as well but I can't remember them making as big a deal about it as
they did this time. Has anyone had to have thier newborn go back into the
hospital to be under the billi lights? Briana had her appt this morning to see
her ped. for the first time and he took some blood to ck her billi levels and I
am worried that they are going to call me and make me take her back to the hospital to be under the lights....
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freestyler's Avatar freestyler 03:50 PM 05-18-2006
First of all, don't panic. It is OK! It isn't whether they are positive or negative per se, it is whether they have an "incompatibility" with their OWN positive/negative other blood reading. Anyway, no one can "make" you take your baby back to the hospital! She is YOUR baby, YOU make the decisions. Our first and our fourth babies had this issue, and yes, they were a tiny bit jaundiced, but not so much as to NEED the lights (like when they risk being brain damaged because of off-the-chart numbers, and some moms here can tell you what those numbers are, I've forgotten.) Ask that the medical personnel tell you her numbers and also ask what the danger cut-off is. Ask for the absolute, undiluted, unexaggerated truth about this, because you are more likely to get the truth this way.

Does she have jaundice symptoms? Yes, there is asymtomatic jaundice but this is pretty rare. If her skin or the whites or her eyes are yellow at all, just start nursing furiously, and be sure to strip her down naked except for a diaper, and sit in the sun with her three or four times a day for 15-30 minutes each time. Not in the hottest, sunburn time of day, but just enough so that some sun exposure will help get her body to process that bilirubin. Heck, nurse furiously anyway, it will only do her good. Certainly it will keep jaundice at bay, unless she has a serious case of it (unlikely.)

The bili-lights are rather controversial. Be sure to get lots of input from moms on this list. With our baby born in October, she was fairly jaundiced at birth, but I refused the lights and nursed like a fury, and sat in the sun with her by my hospital window every time there was sun. It worked like a charm. If her numbers had gone way up, to the danger point, yes I would have done the lights. I'm not going to let their health be in danger. But it certainly was nowhere near that point, and my hunch tells me that your baby isn't either. So many docs are scaremongers. UGH.
ellymay's Avatar ellymay 04:27 PM 05-18-2006
She does have it I just don't know if it is bad or not but apparently it is pretty bad bc her ped. today made the comment that she should have been
seen earlier with her being that jaundice. The whites of her eyes are VERY yellow and her face and chest are pretty yellow and her gums are really yellow. Today is the first day that it has been warm enough to take her out and the first time the sun has really been out it has rained alot the past week. I just got in from taking her out for about 10 minutes and I am fixing to take her out again. I am so worried that she will need to go back and I don't think I can handle her having to be there and I know I don't "have to"
take her in but I don't want the levels to get so high that it causes nerve
damage. I am trying to not worry to much but it is hard. She has been nursing like crazy today she has started wanting to nurse every hour again
and she is eating alot when she does not just a little.
MOM2ANSLEY's Avatar MOM2ANSLEY 05:52 PM 05-18-2006
Jaundice can be very serious....brain damage, hearing loss etc
You can sit in sunlight through your window and not go outside
If she does need phototherapy (lights) , it can be done at home, and then you can take her to office to recheck bili levels, in RARE cases if the bili goes too high a blood transfusion can be required (that probably would have alreadhy happened if your dd needed it)
Just stay on top of it b/c if her bili goes up on the weekend you might not be able to get a light at home and have to go in hospital
That happened to us, Dd's bili went up on a Sunday and we couldn't get a light at home...had to go in hospital, Monday her bili was down some but want up when we took her off the lights so she needed more phototherapy, so we were gonna go home with a light......but her bili was like 0.5 lower than what the insurance company required before they would pay for home phototherapy....so we had to stay another day in hospital. .....Makes no sense I'm sure it would have been cheaper for the ins company to pay for a home light than another day in the hospital. Sorry to ramble, my point is phototherapy may be necessary, but you have options...and keep nursing the bili is excreted in urine and stool, but the light helps break it down so that it can be excreted. Good luck
freestyler's Avatar freestyler 06:39 PM 05-18-2006
Yes, right on Mom2Ansley. And those symptoms do sound pretty serious. If it were me, I would get off the computer and take the baby back to the hospital---"Here, fix this please!" Please get right on it for your baby's safety. There are way worse things than having to return to the hospital.
ellymay's Avatar ellymay 11:23 PM 05-18-2006
I got a call from her ped this afternoon and her level is at 18.9 and he said
that really she shouldv'e been back in the hospital a couple of days ago and
that he is going to let me stay home tonight but I am to make sure that she
eats atleast every 2-3hrs and to offer her 1oz of formula after she nurses
and to bring her back first thing in the morning to have her levels cked again
and if they havn't droped some then she will have to go immediatly to the
hospital. I can't stop crying I don't want her to have to go back and I feel
like it is my fault for not noticing her being so jaundice but she really didn't look that bad and I didn't know that the whites of her eyes being yellow was
a sign that it was getting worse.
MOM2ANSLEY's Avatar MOM2ANSLEY 01:37 PM 05-19-2006
Ellymay, don't beat yourself up over it,
1. Yor ped should have sched an earlier follow up- they knew coombs +
2. They should have educated you better on what to look for
3. Yellow eyes don't always indicate a HIGH bili( ds's eyes gums etc stayed yellow for about a week and his bili at that time was around 12) Our ped said at that point---about 10 days old, it was probably ok unless the lower half of his body was yellow---stomach, legs
Sending hugs your way. Good Luck
ellymay's Avatar ellymay 03:34 PM 05-19-2006
Thanks I took her this morning and he said she looks like it has come down
so we'll see he is supposed to call me this afternoon to let me know what
the number is. Her ped was very upset that I didn't come in on monday but
I told him I tried to make an appt for Monday and the receptionist said they
didn't have anything and he was very upset that they told me that so I am
sure someone got an earfull over it.
*Jessica*'s Avatar *Jessica* 05:20 PM 05-19-2006
Both of my babies have been Coombs positive. My first, Nikolai (31 months) went back under the lights at 5 days old. He was (appropriately for an October baby) as orange as a pumpkin. His level was almost 19. He was nearly impossible to wake to nurse, it was awful. Our insurance would not pay for an at home bili blanket, but we were so lucky to be in a tiny hospital that allowed me to have one of their rooms and they put Nik in his little bili oven right in my room. (They were even so nice that they ordered a pizza for Marc and I one evening and brought us doughnuts one morning!) The doctor agreed that formula wasn't necessary and made sure that Nik was removed from the incubator every two hours to nurse around the clock.

My second baby, Nathaniel (10 months), was also Coombs positive at birth so they decided to keep an eye on him from the start to be sure his levels didn't rise like his brother's. We sat in a sunlit window as much as we could (much easier in July than October in Western New York) and his levels never went above 13.

Experience and research have made me believe that the best thing you can do is to get that baby some sunlight (but inside in the window...there is no reason for you to be out in the direct sunlight) and nurse, nurse, nurse as much as you can make her (formula is unneccessary.) Those heel pricks to check bili levels are heartbreaking, so many hugs to you and Briana!
ltk's Avatar ltk 08:07 PM 05-20-2006
Hi Elley May, I know you from the May due date club. My babe was born Coombs pos/jaundice too. Don't worry, she will be fine.......it's your decision about putting her in the hospital. You can ask for home care, w/ a nurse to come out and check her blood every day or two. And if she is nursing and you are putting her in the indirect sunlight, I am confident it will go down. Also, there is a nursing supplementation system by Medela that can help if you want her to get extra fluid (organic formula?) I was going to try this after my babe was in the hospital bottle fed for two days. He is 10 days old now, bili is 10 or probably below now b/c he nurses NON STOP (another issue all together!!)......good luck and email if you want to commisserate. I hated the hospital, the lights, and their discouraging attitude when all I wanted to do was FEED him! good luck.
ellymay's Avatar ellymay 08:48 PM 05-20-2006
Thanks y'all her levels were down to 15 yesterday so they have droped quite
a bit in one day and I am not giving her anymore formula not only did she NOT
like it but I just didn't see the point when she is already nursing so much anyways. All together she only got maybe an oz of the stuff and I am sure that didn't make her gain 2oz in one day which is another reason he wanted
me to give it to her to make sure she got enough calories. I had her out in the sun for over an hour Thursday afternoon we don't have a window that gets sun in it to sit her by so I had to take her out but she loved it she just
layed there content as could be. I took her out somemore this morning before it clouded up. She is looking a whole lot better now too. I am soo relieved that it had come down so much.
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