Expert: Catherine Beier MS CBE - 11/12/2008

Question
Dear Dr

After looking at your experience and your answerd question I would like to take this opportunity to ask this question.

Last week my wife gave birth to our baby boy. The birth was a through a normal dilivery and the heatlth of my baby was good(2.6 kg) having no jaundice. Two days latter when I take my wife and baby to home, my baby got jaundice. I took him to the hospital who admit him for the photo therapy. 2 days after the level of bilirubin falls from 1.54 to 11, as a result hospital discgharge my baby. 2 days after I took him  back to the home, he again go in the condition of jaundice ( blirubin 14.7). Now he is again in the photo therapy. The baby is 100% on mother feed. However today I came accross a web site ( original text and reference given below) which states that if the blood group of the baby not matches with the mother, it creats severe problems on mother feed if an injection of Rh immune globulin is not given to the mother withing 72 hrs of chlid birth. The website states that the RBC of the chid might effected because of it. Here I would like to mention you that no such injection is given to my wife. The blood group of my wife is O possitive and that of baby is B possitive.

The question I would like you to ask that is this jaundice of my baby is beacuse of the mother feed as both of them has different blood group and no such injection of  Rh immune globulin is given to my wife. If this is the case then we stop immediately the mother feed and give him the formula milk. Kindly reply me as soon as possible as I am alone with my wife living away from my home country and no family member available to discuss.

regards,

Zeeshan

Note: FYI I am giving below the website and original text of the website :

http://kidshealth.org/parent/pregnancy_newborn/common/jaundice.html

Blood group incompatibility (Rh or ABO problems): if a baby has a different blood type than the mother, the mother might produce antibodies that destroy the infant's red blood cells. This creates a sudden buildup of bilirubin in the baby's blood. Incompatibility jaundice can begin as early as the first day of life. Rh problems once caused the most severe form of jaundice, but now can be prevented with an injection of Rh immune globulin to the mother within 72 hours after delivery, which prevents her from forming antibodies that might endanger any subsequent babies.

Answer
Zeeshan,


There is no reason for your wife to have had an RH immune globulin injection.  


The article is a bit misleading because the issue is not with different blood types, but with the RH factor of the blood.

This could only be a problem if her blood was Rh negative and the baby's was positive.  Also, their blood would have had to mix during the delivery, which does not usually occur.


So, there is no way that the jaundice is a result of that condition.  In most cases, jaundice occurs due to the liver not being fully mature enough to filter well.


Increasing the frequency of feedings can help to clear out the billirubin faster so the jaundice clears up sooner.  Phototherapy should also alleviate the problem.



Best,
Catherine