Tuesday, May 27, 2008

The Jaundice Battle

As I'm writing this now, my baby is still in the hospital undergoing the phototherapy. Yes, she has neonatal jaundice, and her level is rather high. When we were discharged (it was Day 2), her level was 9.8 (or 166 in another type of measurment). Since it was a public holiday, we need to go back the next day for checkup and get her blood test report.

When we went to the hospital for checkup on Day 3, her jaundice level had gone up to 13.8, so we had to admit her. I breastfed her and passed her to the nursery. Then I managed to pump out 1 ounce of breast milk for her.

First time's expressed milk

I requested the nurse to spoon feed her formula (since I don't have any stock yet, my milk only came on Day 3). Later, that evening, I passed ~4 oz of EBM (expressed breast milk) to hubby to take to GMC for my baby.

The next day, I called to check on her level. She had to stay another day. Hubby took me to breastfeed her around noon. She was still asleep and refused to drink despite a lot of coaxing. She had been fed slightly earlier, so maybe that's why. However, I could not arrange to come during her feeding hours since hubby could only take me during his lunch time and I don't have a car with me. I then passed my EBM to the nurse. I managed to pump out ~25 oz for her since last night.

The next day, I was expecting her level to go down. It did, but stayed at the marginal level - at 11.3. Her paediatrician advised us to let her stay another day. It might drop another 2-3 points so we would not need to come back for follow-up. We agreed. Again, I was not successful in my attempt to breastfeed her. I passed my EBM to the nurse again. By now, I could already expressed a full bottle of milk at one go. It was the first time I managed to get a full bottle, and I took a photo of it for my own satisfaction :) Not so much colostrum this time...

On the 3rd day, I expected her level to go down. It did not, but stayed at 11.3. Since her level was below 12, she was allowed to be discharged, but we need to bring her back for checkup after 2 days. She went back with me on Friday, and I took 2 days to re-train her in breastfeeding. After returning from the hospital, she refused to suckle but was waiting for me to spoon feed her instead. It took a lot of patience and determination because she would cry everytime I tried to nurse her. It broke my heart to see her cry, and after some 'fight' with her, I gave up and bottle-fed her instead. I was afraid she no longer knew how to suck so I offered her bottle to see how she responds. She took to it immediatly and could suck really well. For the next feeding, I took another attempt to nurse her. Anyone would think that I was torturing her since she cried so pitifully everytime I tried to breastfeed her. I was devastated at first, because I have a lot of supply this time, but not much demand. It was not easy, but after much struggle I finally managed to train her again by Sunday. It was such a relieve, because I thought I was going to fail this time.

While she's back with me, I did all I can to reduce her jaundice level. MIL said that giving her sengkuang juice would help, so I extract a teaspoon of the juice and gave her twice a day.

I also asked the confinement centre where I was staying to bathe her with a type of herbs (air kuning) which is a traditional way to reduce the jaundice level. Apart from that, I put her under the sun for awhile.

And, I've also tried drinking goat's milk since they say that it is good for breastfeeding mothers especially if their children have jaundice. I even gave her some formula since some said this would help the jaundice level to drop faster. I have stopped all my intake on the chinese herbs like soh hup and ginger as advised by the paediatrician.

Come Monday, I took her for checkup. Her level was at 14.2. It was alarmingly high, so we need to admit her again. I asked the paediatrician if I should stop breastfeeding her and use formula instead. He said no. According to him, if this is due to breastfeeding jaundice, then it is not risky. He went on to say that it's not fair to ask the mother to stop breastfeeding since we're stopping the child from getting all the nutrients from breast milk. Furthermore, he agreed that when we switch to bottle, it is very hard for the child to adjust to the nipple again later, which was one of the major reason why mothers failed in their attempt to breastfeed. He also said that we no longer follow the traditional way of sun-bathing our child, since the UV light is more dangerous to the skin, and it's not as effective as the photolight therapy. I also asked him about feeding our child with goat's milk directly. He wouldn't recommend it, nor stop us from doing so, since he said that although there were studies that show goat's milk could reduce jaundice, it might have other effects on the child, such as liver problem, etc. Furthermore, goat's milk is rather new, compared to cow's milk which has longer history of a proven record.

It's Tuesday now, which is my baby's Day 10 since birth. I called the nursery this morning, and was told that her level has dropped to 12.5, which was still considered high and could not be discharged yet. We asked the doctor why is it that she still needs to undergo the photolight therapy since she's already Day 10 (he told us yesterday that this photolight is only effective for babies less than 10 days old). He reasoned that it's still better for her than nothing at all, and for babies over 14 days, the threshold level would increase accordingly. The older the babies, the higher the acceptable threshold would be and we might not need to admit her anymore, but the next step would be to find out the reason behind the prolonged jaundice.

Hopefully her level would go down tomorrow and she would be discharged soon. My heart ached everytime I see how she cringed and cried when her blood was taken, and she seemed to be able to sense it even before the nurse pricked her.


Everyday Healy said...

Huh! It's a long story. Nice to meet you, baby!

But, how come your first time expressed milk so yellow one? Just curious. hehe...

Irene said...

Thanks for dropping by, everyday healy. And nice to meet you too.

Well, that's colostrum, I guess. Just wondering if you're breastfeeding your baby too?

user2 said...

Hi Irene,

I wonder how long did it take for your baby to fully recover from jaundice?

ablogaway said...

Hi user2, I'm not very sure. It's been awhile, and I'm not very good with my memory these days. Anyway, it took very very long for my baby to recover fully, could be more than 2 weeks, but definitely less than a month. I read that for breastfeeding jaundice, it could take up to 6 weeks, I'm not sure if I ever reached that long, but it's nothing really to worry about(if it's really breastfeeding jaundice).


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