avoiding jaundice?? - Mothering Forums

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#1 of 28 Old 08-21-2008, 12:17 AM - Thread Starter
 
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Is there anything I can do prenatally to make sure my little one doesn't have jaundice after birth?? A friend of mine just had a baby and she had jaundice and had to be under the lights for 3 days...ugh that just sounds awful to me.
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#2 of 28 Old 08-21-2008, 12:28 AM
 
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: Another interested mama here...
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#3 of 28 Old 08-21-2008, 12:55 AM
 
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I'm planning to take precautions since DS had breastmilk jaundice for months. Lots of nursing and sunlight, syringe feeding pumped milk if baby is too sleepy. I wonder if a mom took milk thistle if that would help?
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#4 of 28 Old 08-21-2008, 01:13 AM
 
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Nothing prenatally really, but the type of birth can impact it. If there is bruising from the birth, that can contribute to jaundice--of course sometimes bruising occurs during the best and most natural of births, but avoiding difficult birthing positions and vacuums/forceps, etc can help. And of course letting baby go full term and on it's own schedule (ie avoiding induction) if at all possible--preemies, even by a week or two, are more susceptible.

The very best thing to do is breastfeed early and often. It's normal for a newborn (after the first 24 hours or so) to want to be on the breast almost constantly. It hardly needs to be said here, but don't fall into the trap of thinking that baby is "using you as a pacifier" or needs to be put on a feeding schedule.

Despite best efforts, some percentage of newborns will go on to develop jaundice. This isn't necessarily a bad thing. . . there is some evidence that mild jaundice actually benefits the baby (acts as an antioxidant, helps baby's immune system). It's only when the levels get really, really high that it becomes dangerous. Most true cases of kernicterus (brain damage occuring from jaundice) don't involve healthy, full term newborns--there are other compounding factors.

And definitely read up on it so you know how to handle it if it comes up. . . some docs will tell you to give formula to bring the levels down (rarely necessary). I had a doc to tell me to give my daughter water because "she isn't going to get over this on JUST your breastmilk" : I still wish I'd sent him a copy of the AAP statement on dealing with jaundice and highlighted the portion that says water is contraindicated.

Oh, and consider using physiologic jaundice and avoiding the term breastmilk jaundice. I think it would be nice if the medical community would quit BLAMING breastfeeding for jaundice, as if formula is somehow the gold standard. Just my little soapbox rant

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#5 of 28 Old 08-21-2008, 04:54 AM
 
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Hmmm...I don't know of anything prenatally (but what do I know anyway -- lol). I would definitely second the recommendation to breastfeed OFTEN after birth. Also, spend time in the sunlight with the baby. Go by a window, sit with the baby in your arms, and expose a large portion of his/her back to the sunlight for about 10 minutes a few times a day.

My son (hospital birth) had jaundice and we did the billi-lights (which I regret that I wasn't educated about beforehand...it wasn't really necessary at all in his case...sigh, ah well). I was determined to keep jaundice at bay from my daughter (home birth). So, we did the nursing all the time and, like I said, spent a little time in the sun each day (now, I don't mean baking in the sun for hours at a time -- lol). I would hold her like I mentioned or I would lay her down while she slept on the Boppy pillow in front of the window and pull up the back of her pj's so her skin could absorb the sun's rays.

It all worked like a charm. No jaundice at all.

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#6 of 28 Old 08-21-2008, 11:00 AM
 
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Yes there is something you can do prenatally. Shonda Parker (professional herbalist) says in her book the Naturally Healthy Pregnancy, that taking Milk thistle in the last weeks or so of pregnancy and postpartum helps prevent Jaundice in the baby. I have read this at least one other place maybe even two.
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#7 of 28 Old 08-21-2008, 11:07 AM
 
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Something I just learned that is slightly off topic:

If one parent has O blood type and the other has A, the baby has a very high chance of having "early onset jaundice" (there is another name for it too)

I had a pretty good case of jaundice as a baby (mom O-, bio father A+, me A+) and had to be under the lights, and never knew untill this week that that was the cause. My mother was never told this either (not sure if they knew about it back then) so it was an interesting thing for both of us to learn.
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#8 of 28 Old 08-21-2008, 11:11 AM
 
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Oh thanks Herbsgirl! It seemed logical to me but I wasn't sure.
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#9 of 28 Old 08-21-2008, 11:35 AM
 
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Can't remember in where I read it but there is some interesting research out there that looks at the possible protective antioxidant effect of bilirubin on a nb babe...suggesting that jaundice might not be as much of a bad thing as we think it is. Of course, high bili levels can lead to kernicterus so it was all relative.

Interesting food for thought though.

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#10 of 28 Old 08-21-2008, 11:37 AM
 
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Tiger Lily, you have so much information on this! I like the milk thistle idea too, herbsgirl. What is the link between the Vitamin K shot and jaundice? I heard it a while back, but do not remember. All I remember is that I was going to write it into my emergency transfer to hospital plan that I would be refusing the eye ointment and the Vitamin K shot.
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#11 of 28 Old 08-21-2008, 12:24 PM - Thread Starter
 
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If one parent has O blood type and the other has A, the baby has a very high chance of having "early onset jaundice" (there is another name for it too)
well that stinks...i'm O and My dh is A...

My first son never had jaundice but my second son had it slightly...I just nursed every 1-2 hours until he started pooping alot and then that seem to get it out.

I will look into the milk thistle...is it an herb? tea??
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#12 of 28 Old 08-21-2008, 12:30 PM
 
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I'm O+, dh A+, ds A+ -- he was yellow at birth, yellow for about 3 weeks, even the whites of his eyes were yellowed (everyone asked what was wrong with him, grr!), but they said he wasn't jaundiced. I wonder if it was just mild and as a result of our blood types? That is very interesting. I think taking milk thistle certainyl couldn't hurt!

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#13 of 28 Old 08-21-2008, 12:32 PM
 
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Not in you DDC - but saw this in the new posts and thought I would share this link. There is more info out there, but this is what I found in a quick search:

Vitamin K and Jaundice from the package insert

Quote:
According to the product insert, adverse reactions include haemolysis (or hemolysis - American spelling) (meaning breakdown of red blood cells), haemolytic anaemia (a disorder characterised by chronic premature destruction of red blood cells), hyperbilirubinemia (too much bilirubin in blood) and jaundice (yellow skin and eyes resulting from hyperbilirubinemia), and allergic reactions include face flushing, gastrointestinal upset, rash, redness, pain or swelling at injection site and itching skin. It also warns that large enough doses can cause brain damage in infants and/or impairment to liver function. Hypoxia has also been published as having occurred in infants after Vitamin K administration
and THIS

Quote:
Although allergic reaction is possible, there is no known toxicity associated with high doses of the phylloquinone (vitamin K1) or menaquinone (vitamin K2) forms of vitamin K (22). The same is not true for synthetic menadione (vitamin K3) and its derivatives. Menadione can interfere with the function of glutathione, one of the body's natural antioxidants, resulting in oxidative damage to cell membranes. Menadione given by injection has induced liver toxicity, jaundice, and hemolytic anemia (due to the rupture of red blood cells) in infants; therefore, menadione is no longer used for treatment of vitamin K deficiency (6, 8). No tolerable upper level (UL) of intake has been established for vitamin K (22).

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#14 of 28 Old 08-21-2008, 01:44 PM
 
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Great info ladies! I'll add milk thistle to my list of things to get at the health food store today (gotta get papaya and cal/mag too). I'm O- and DH is O+ so the blood type doesn't seem to be a problem as it relates to jaundice but anything I can do to help deter unhealthy jaundice would be great.
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#15 of 28 Old 08-21-2008, 01:53 PM
 
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And to think the vitamin K is the only thing they talked me into. For the longest time I couldn't remember if I'd allowed it or not so I had to look in the baby book the other day. Sure enough... after how well the transfer went I felt like that was the one thing I could stand to bend on. The home visit nurse FREAKED OUT about his bili levels and weight and tried to convince me he was "fake" nursing, starving and jaundiced. His levels never got dangerously high but boy was he yellow! He was a 36 weeker btw.
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#16 of 28 Old 08-21-2008, 02:09 PM
 
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I didn't know about the Vit K connection so I'm glad I had other reasons for declining that! More info=more ammo when declining!
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#17 of 28 Old 08-21-2008, 02:47 PM
 
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Here's what I think is a very well written, informative article on the link between vit.K and jaundice. I hope it's OK to put a link to another forum on here?
http://www.welltellme.com/discuss/in...html#msg158681

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#18 of 28 Old 08-21-2008, 02:59 PM
 
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Originally Posted by sweetestday View Post
Here's what I think is a very well written, informative article on the link between vit.K and jaundice. I hope it's OK to put a link to another forum on here?
http://www.welltellme.com/discuss/in...html#msg158681
Good info...but all those mamas planning on chopping up their babies genitals made me throw up in my mouth a little:Puke

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#19 of 28 Old 08-21-2008, 03:00 PM
 
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Originally Posted by Kim919 View Post
If one parent has O blood type and the other has A, the baby has a very high chance of having "early onset jaundice" (there is another name for it too)
Yes, they call it AB/O incompatibility. I'm O+ and DH is A+, but neither of our kids have had it (my second developed jaundice, as you'll read, but it wasn't THIS type). . . they run a test called a Coombs test to check for it. I'm not sure if it's routine to check this or not--both my kids had a "reason" for them to check.

My first was born with the help of the vacuum and had a horrible, perfectly round bruise on his head, so they monitored him closely for jaundice (which he never developed).

My second was born (after a membrane stripping--never again!) at 39w4d and came out looking and acting like a 37 weeker. I had a ton of trouble getting her to breastfeed properly and she lost too much weight and got dehydrated. She developed case of physiologic jaundice and was yellow for the first 5 or 6 weeks of her life. She was actually readmitted to the hospital at 1 week of age because she was so sleepy and lethargic we couldn't get her to eat (and believe it or not, she was born in JUNE in CA and it rained almost the entire first week of her life, LOL. No sun!). Her bili got up to 19.6 which is fairly high (I think 21 is considered "dangerous"). After 24 hours of fluids and lights, her levels dropped down to 11, but they rose back up to 15 within 24-48 hours before they finally started dropping on their own.

The whole thing was a nightmare! The doc told me that babies are generally born with an immature liver and it takes a few days for their liver to start kicking out an enzyme that processes bilirubin--which is why so many of them develop it. You can imagine in a baby who is early even by a little bit is more susceptible. Hence the reason I will NEVER consent to any induction methods again unless there's a sound medical reason for it!

Oh, and something else crazy? They checked her bili when we left the hospital at 24 hours and it was an 8. I can't recall the name right now, but there's actually a chart that can predict their risk of jaundice based on early reads. 8 was quite high for 24 hours and put her in the "high risk" category. . . and nobody caught it, probably because we'd been transferred to peds due to overflow on the OB ward. Granted it was a transdermal reading, but my mom, who is an OB nurse at that hospital, said that the reading should have been caught and double checked. Last summer I sat in the session on jaundice at the LLLI conference in Chicago and looked at this chart that the presenter distributed and was horrified. She followed the trend perfectly. When I asked my mom about it later, she said that they do indeed have those very charts available for their use!

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#20 of 28 Old 08-21-2008, 03:04 PM
 
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Also, even if a baby has jaundice that needs to be treated, they should not have to stay under the lights away from mama; the hospital should have a bili-blanket that baby can be wrapped up in and held. And they should be able to send you home with that instead of keeping your prisoner in the hospital.
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#21 of 28 Old 08-21-2008, 03:04 PM
 
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^This is a totally OT question but can I ask why you'd never allow stripping of memebranes again? You don't have to answer if you don't want to or can PM me if you prefer.
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#22 of 28 Old 08-21-2008, 03:20 PM
 
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Originally Posted by paquerette View Post
Also, even if a baby has jaundice that needs to be treated, they should not have to stay under the lights away from mama; the hospital should have a bili-blanket that baby can be wrapped up in and held. And they should be able to send you home with that instead of keeping your prisoner in the hospital.
Unfortunately not all hospitals have these. . . mine didn't. I'm not sure that lights were even necessary when the bili was at 8. I just would like to have KNOWN that it put her at "high risk" so I could take some extra precautions (like jumping on the breastfeeding issues sooner than I did).

My DD was actually readmitted for dehydration and they went ahead and did 24 hours on the lights as well (jaundice and dehydration tend to go hand-in-hand). I was able to stay with her the whole time, take her out frequently to breastfeed, and I spent a lot of time with my arm inside the incubator. Bili blankets are also not nearly as effective as the incubator type lights. I'm not a big fan of jumping for phototherapy automatically when jaundice is present. But since her levels were so high and they rose AGAIN after the phototherapy was discontinued, I think it was the right choice. This wasn't the standard newborn jaundice, remember.

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^This is a totally OT question but can I ask why you'd never allow stripping of memebranes again? You don't have to answer if you don't want to or can PM me if you prefer.
It's actually NOT an OT question I think she probably would have stayed put a bit longer if I hadn't had my membranes stripped. Like I said, she was born at 39w4d and came out looking and acting like a 37 weeker. I'll spare you the details, but I was QUITE sure of my dates, too, so I kind of think she was just a "slow cooker" and might have gone "overdue" a bit. The fact that she had the maturity of a 37 weeker vs a 39-40 weeker compounded the problem quite a bit--we had breastfeeding issues and her liver was that much more immature.

I could be way off base here--she might have just come then anyway, because I think the rate for membrane stripping is only 50%. But my personal feeling is that it contributed.

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#23 of 28 Old 08-21-2008, 10:24 PM
 
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Originally Posted by Tiger Lily View Post
Yes, they call it AB/O incompatibility. I'm O+ and DH is A+, but neither of our kids have had it (my second developed jaundice, as you'll read, but it wasn't THIS type). . . they run a test called a Coombs test to check for it. I'm not sure if it's routine to check this or not--both my kids had a "reason" for them to check.
This is very interesting - I'm A- and my older kids' dad is O+ ; my DH is also O+

My kids have all gotten a little yellow but not too much. My midwife always advised me to "sun" them a little bit every day and to nurse frequently.

They've never had a test done that I know of, but their cord blood has been tested right away since I'm Rh- so maybe it's done in that. They were all home births.

I'd like to avoid any yellowing this time around but pretty much just plan to go with the same tactics - lots of nursing, and letting baby get some indirect sun and sunning for a few minutes front and back morning and afternoon

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#24 of 28 Old 08-21-2008, 11:06 PM
 
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Thanks TigerLily! I figured it was because you didn't want to risk an underdeveloped baby but I wanted to make sure there wasn't another reason like it started the slippery slope of interventions. I appreciate you sharing!

I got some Milk Thistle today at the health food store.
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#25 of 28 Old 08-22-2008, 12:19 AM
 
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Even if your hospital does not have bili blankets, you should be able to rent one from a medical supply store, even if they have to order it. Just have it over-nighted. Much better than putting the baby under the lights and separating them from mama.
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#26 of 28 Old 08-22-2008, 03:19 AM
 
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Thanks TigerLily! I figured it was because you didn't want to risk an underdeveloped baby but I wanted to make sure there wasn't another reason like it started the slippery slope of interventions. I appreciate you sharing!
Sure It actually didn't lead to more interventions for the birth. I went on to have a pretty nice hands-off hospital NCB. That was part of the reason the whole thing was SO frustrating. . . it was like, "Hey I did this 'right' and now she won't breastfeed and she has this huge jaundice problem!"

Anyway, I didn't mean to turn this thread into Tiger Lily's Jaundice Saga :

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#27 of 28 Old 08-23-2008, 04:47 AM
 
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I feel really blessed, I am O, hubby is A and neither of our kids were remotely jaundiced.

As a side note for Tara, I had my membranes stripped twice (my son was born 9 days late after being induced) and that never even worked for us. But Castor Oil did the trick with my 2nd.
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#28 of 28 Old 08-23-2008, 12:21 PM
 
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