Worried (Weight gain and jaundice)

[ButtonJessie]

Just been to the health clinic and had Lola weighed. She's 5lb 11oz now, which I thought was good but they said shes only JUST putting on the recommended 4oz a week and they want me to start topping her up with a bottle of expressed breast milk after each feed. We haven't started weaning her off of the nipple shields yet so I'm worried that if I'm bottle feeding her too she's going to struggle with a naked nipple. I wasn't going to start trying to wean her off them until shes term (7th Jan). SIGH.

Also, she was supposed to have her SBR level (jaundice) checked at 21 days but it was over Christmas. So I asked when I was there and they said "oh yes, she is VERY yellow", I'll ring the hospital and remind them. So I've just had a call from the hospital and I have to take her in for a test at 2pm. Firstly, the test is horrible, they have to squeeze quite a bit of blood out of her heel, and secondly I'm TERRIFIED she's going to need phototherapy again because last time she HATED it and since she's been home she's gotten usedto lots of cuddles and stuff so she's going to freak out if she cant be picked up. Really dont want to see the New Year in back in hospital

Just needed to vent that, sorry!
xxx

 

[summer rain]

Hi

My little one was term but has the same jaundice problem, it runs in both dh's and my family so our babies have all been unwell. My son was readmitted on Monday night and they gave him the phototherapy for about 16 hours then took him off and observed him for another 24 his levels went back up and then dropped dramatically but he has to go back on Tuesday evening and have the SBR again as well as tests for underlying causes. They wouldn't let me stay with him on the first night last time and I was heartbroken, they ended up giving him formula as there was no way that I could express enough milk at such short notice, which I am just so upset about. This time I'm expressing milk daily so he should have enough by Tuesday-should he have to go back in.

With them saying you need to give expressed milk, would you be able to give it via a cup or syringe?

Please update on if your LO had to go back in or not. All the best xx

 

[summer rain]

Hope all is ok...

 

[ButtonJessie]

Hi Summer Rain

Her SBR came back as 220 which they think is overly high for her age. She is still pretty yellow, but doesn't seem lathargic.

The took blood test to check her thyroid, liver and kidney function and we spent about an hour trying to get a urine sample from her! All tests have come back clear, so they let us come home thankfully.

They've told us to just give it time, and if she doesn't look any better in a week or so they will test again. I'm trying to get as much milk down her as possible in the meantime, and get her in the sunlight when I can.

Sorry to hear your little one is having jaundice troubles too. Fluids and sunlight are the only things we can do to help really. Let me know how his SBR check goes on Tuesday

xxx

 

[summer rain]

Hi

glad to know they let you come home and hope next weeks test goes ok; hope same happens for us, my son's levels were 232 on discharge but I'm really not sure if they have gone back up or gone down he still looks very yellow; but my eldest who was discharged from outpatients only at 12 weeks (despite being under phototherapy with 4 lights for 90 hours) and who continued to have low levels of jaundice for an extra 4 looked really really yellow (including the whites of his eyes) until his levels fell to 50 so its so hard to tell. He's getting plenty of fluids/food and the hospital realise that at least; with my eldest attitudes were a lot different. Just wish there was more sunlight around! I think thats why my two middle ones had jaundice for about three weeks; but not really any longer; because they were born in the summer/early autumn and so we were able to expose them to a lot of sun and daylight.

 

[lozzy21]

If shes still putting weight on i dont get why they told you to top her up, aslong as shes putting on weight shes obviously getting enough, some babys are just slow gainers.

 

[25weeker]

In the 8 months my lo has been home she has only put on more than 4oz a handful of times but as she is following the 0.4 centile in the growth chart the HV is happy with her.

Over the next few weeks you should see how she gets on and as long as she is content and having plenty of wet nappies if you aren't happy giving her a bottle then hold off. It sounds like your HV is comparing to fulltermers and at the end of the day you don't have to follow their advice.

Hopefully the jaundice will clear up soon

 

[summer rain]

Just reread your original post, after every feed does seem a bit excessive, usually they advise once a day, 4oz a week is fine anyway but unfortunately the way the charts are, even the new WHO ones, if your baby is born on one of the higher percentiles than those at the very bottom they often have to gain 8-10oz a week to keep up with their line on the chart, HVs never seem to realise this.

 

[summer rain]

My LOs levels on the normal bilirubin check had shot up to 338 It's not quite requiring phototherapy but we have to go back on Friday, my son regained his birthweight now and he went down to 7 lb 8 a week after birth, so in 8 days he's gained 9 or 10oz back so they are satisfied he's getting plenty of food/fluids but it's having no effect. The exact same happened with my eldest, the phototherapy only worked temporarily and then there was a massive rebound.

 

[ButtonJessie]

Oh bless him I have been putting Lola's moses basket in the window while she sleep so that she can get as much sunlight in the daytime hours as possible and it really does seem to be helping. Could you try that? Other than that, you're doing a great job with the feeding so there's nothing else you can do. It will go down eventually. Have they run blood tests to check his liver/kidney function yet?
xxx

 

[summer rain]

I put him in front of the patio window everyday in his bouncy chair from morning until about 3pm only taking him out for feeds or if he is crying; its made no difference whatsoever They have run the whole gamut of tests twice already and they were fine (including liver and kidney function tests and even tests for a rare enzyme deficiency); but for some reason they are insisting on re-running them all on Friday. They are also testing his thyroid function. They did the SBR again as well but said they will get the results of that on Friday, they said the other level the one only in double figures can't remember if its conjugated or unconjugated bilirubin was always quite low; so thats a good sign they said.