Newborn Jaundice, Again

When my oldest son, TJ was born in 2009, my husband and I had no idea he had a handful of risk factors for developing newborn jaundice. He was born a few weeks early, he was half Asian, and there was a family history, I had it as a newborn. So when we headed home from the hospital 36 hours after he was born, no one warned us or explained how often we should have been feeding him. I had been taught to nurse him on demand. He was a sleepy newborn, which is normal, but we didn’t know we should have been waking him up to eat every few hours rather than letting him sleep. When his skin started to get a yellow tinge to it, we honestly thought it was just the olive complexion he got from his daddy.

Chalk it up to first-time-parenting combined with on-the-job-training!

At seven days old, his bilirubin was 19. We did two nights of at-home light therapy with a bili-blanket and it continued to rise to 21. At that point, we had to bring him to the hospital to spend a few nights under UV lights.

We learned a lot about jaundice, bilirubin, and the NICU back then. The biggest lesson we learned was that him being in the NICU was unnecessary. He had no other health problems and we were at a children’s hospital. We could have requested he have his own room where I could have stayed with him 24-7 rather than in the NICU where I was only allowed to nurse him twice every 12 hours. Bili-lights can be moved! The NICU pediatrician insisted he receive formula the first 12 hours he was there too, something else I learned is inaccurate and outdated advice and was unnecessary. You can read all about our experience with his jaundice and the NICU here.

When I got pregnant with my second baby four years later, I kept an open line of communication with my midwife throughout my pregnancy so we could hopefully avoid another hospital stay.

M was born at 39 weeks rather than 37, so we had one less risk factor to worry about. The only major risk factor both of my boys didn’t have was their blood type, it was the same as mine.

At 24 hours old, my midwife clipped his tongue and lip ties, making him able to breastfeed more effectively. I was nursing him every 2-3 hours around the clock, and waking him up to nurse. I knew the more he ate, the more bilirubin would be flushed out. My milk came in full force just 36 hours after he was born and I often nursed him outside, in direct sunlight, hoping to help him absorb more vitamin D and also help get rid of the bilirubin. It was mid April, so the temperature wasn’t a worry.

Image by Earthside Birth Photography

My midwife had me bringing him in to check his bilirubin starting at just two days old. We watched it slowly creep up. A little high is normal in newborns, but there’s a point where it gets too high. At 48 hours old it was at 13, three days: 14.5. At day four it had jumped up to 19.5. I still remember the tone in my midwife’s voice when she called me.

Off to the local children’s hospital we went with our newborn… again.

The quickest way for us to get him admitted (according to our pediatrician) was to come in through the ER. Thankfully the ER was empty that afternoon. I snoozed on a bed with M on my chest while we waited for his bloodwork to confirm that his bilirubin was high enough for him to be admitted.

A couple of hours later, we were in a hosptial room with M in a crib and him lit up like a blue Christmas tree.

The experience was both easier and more difficult than it was with my oldest in a variety of ways.

We had our own room where there was a place for me to sleep. I was able to nurse him on demand with the support of the nurses and doctors. Only one resident hinted that she would have preferred that I pump and give him a bottle so she knew exactly how much he was getting. I smiled and told her I’d consider it. I really would have if he was struggling with a bad latch, but he wasn’t.

I was able to stay with him the whole time, which also meant that I didn’t sleep for almost three days. He was only four days old when admitted, so he had no idea how to sleep on his own without being close to me. I spent hours with my hands touching him to keep him calm, especially after they put the eye goggles on him. The bili-lights were both above him and under him, so having him sleep on me with light above wasn’t an option they were willing to consider.

Every diaper was weighed and I documented the times and duration for each feeding.

Nursing with him hooked up to leads and monitors was tricky, but not impossible. I tried my best to nurse him quickly so he could get back under the lights. I knew that the more time he was there, the sooner we could go home.

After the first sleepless night, I figured out that it was easier to just whip out a breast and hover over him to let him nurse rather than move him and disturb the lights. The nurses we had were amazing and friendly and so, so wonderful. They all laughed when they walked in to see me hunched over the crib breastfeeding him.

We stayed for two nights and three days before heading home. We had to check in with our pediatrician every other day to have his bilirubin checked. It’s not uncommon for it to rebound after he’d been off of the lights for a bit, and there’s always a risk it can get too high again.

It did.

We really didn’t want to go back to the hospital, so we opted to do at-home light therapy with our pediatrician’s blessing. We were sent a couple of light paddles that went against our son’s chest and back while we held him. At night he slept on a light unit that looked like a flatbed scanner or a Xerox copier.

We had to do home therapy for almost three weeks before his bilirubin would stay at a safe level. In hindsight, I don’t regret the decision to stay home rather than go back to the hospital, but it was rough to trek out to the pediatrician’s office every other day only to see his bilirubin come down less than one point.

At least at home we were able to sleep in our own beds and we spent many, many hours snuggling on the couch binge-watching TV and movies. The light therapy was a minor inconvenience that forced us to stay home and allow me to actually recover from childbirth (including a postpartum hemorrhage!), which is really hard when you have to be with your baby in the hospital!

I did suffer from cabin fever for a while, but going out on a few walks in the beautiful weather with my baby in a ring sling and my oldest on his bike helped a lot.

All in all, my poor son’s heels were poked 32 times in a span of three weeks.

Jaundice sucks and it can affect a lot of babies, but I think we forget that it can be a serious condition in some. I remember feeling a little bit of hormonal rage at a few parents who said “we just sat in front of a sunny window and all was well.” We did that too!!!

Lessons learned: No matter how you can hope to prevent jaundice, sometimes you can’t fight family history.

Image by Cari Hollis

Have you had to deal with jaundice in any of your newborn children?

One Response to Newborn Jaundice, Again

  1. I’m glad it worked out in the end. I can’t believe they only let you breastfeed TJ every 12 hours. That is nuts!

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