Coombs Positive

When the doctor said our baby was Coombs Positive I had no idea what that meant.  She delivered the news with such a solemn expression that my heart leapt into my throat as I imagined all the terrible things this could mean for our family.  

As I held my 12 hr old infant in the hospital bed the pediatrician explained that it is a type of jaundice.  I could feel my anxiety level drop as I thought, "Oh jaundice?!  What's with the solemn expression?  Davey had that, we'll just stick her on a blanket in the sunshine a couple times a day."  As the doctor continued her explanation I began to understand her expression.  Apparently there are several types of jaundice and that Kylea has a somewhat rarer and more serious kind caused by a blood type incompatibility. 

Blood cells have multiple kinds of proteins about them, which make them unique there are two types of proteins which most people are familiar with the RH factor (which makes your blood positive or negative) and the ABO type.  Kevin has positive blood and mine is negative so I was given a Rogam shot during pregnancy and after delivery to protect both Kylea and a future baby from an immune response that attacks foreign bodies (leading to miscarriage) so the RH factor wasn’t the issue.  The problem was that Kylea’s blood is type A and mine is type O and apparently type O blood doesn’t mix well with type A or B. 

During delivery there was some cross over between baby's and my blood.  Since our blood types are incompatible all of my blood cells died in her body and became waste that her tiny body is now responsible to get rid of. As an added bonus the fact that our blood cells are incompatible causes some of Kylea’s own blood cells to also die and add to the waste that she must get rid of.  This waste backs up in the liver and when the liver is backed up bilirubin levels rise.  This rise can happen very quickly in Coombs positive babies and so immediate action is taken.

So my brand new chubby little angel was taken away to spend the majority of her day under lights specially designed to break down bilirubin. 

There is no doubt that I was much more emotional after delivering Kylea (a fact which my midwife had warned me of) so being separated from my first born and seeing her with her eyes covered all alone in the nursery whimpering was more than I could handle.  I broke down into teary sobs right in the middle of the nursery.  The nurses looked at me like I was high on drugs (rightly so) and said, "you know this isn't life threatening."  Of course I knew that, but everything is much more tragic when you're hopped up on post pregnancy hormones.

After a lot of coaxing the pediatrician prescribed us some billi lights so we could take our little bug home and continue treatment on our own.  We were ecstatic! To make sure that Kylea was getting the best home treatment possible we were sent home with the "billi suitcase" which looks like this

And the wallaby, which fit into the bottom of the suit case so that she could get lights on her back as well.  The wallaby looks like this.

All put together the set up looks like this.  

I don't know about you but watching your tiny baby from across the room for the first 2.5 weeks of her life is not exactly the way I envisioned bringing home my first baby.  Probably the most difficult part of the whole deal was that we were instructed to leave her in there all day except for when she was eating and to NEVER go to sleep or leave her unattended (in case the eye wear came of....which it did more than once) this meant sleeping in shifts and since I am breastfeeding it more fittingly meant no sleep.... ever.

We did get to take her out of the lights for a once daily excursion to the hospital for a heel poke so they could check her bilirubin levels.

putting on heel warmer so she bleeds well when they poke her

Daddy is just as sad about the heel poke as baby is.

The heel pokes got harder and harder for us to do to her as her tiny feet were filled with the scabs and scars of previous pokes.  

So, after a couple weeks of lights (initially they had said one week max), 48 hours on formula (which was enough of an adventure to deserve it's own blog post) and a heel poke a day for the first month of her life we are now FINALLY on the road to recovery.  We are back to breast feeding, off the lights and don't have to get another heel poke until next friday (jumps for joy!)  if the levels are continuing downward at that check then we are officially done with heel pokes!

It's really ironic that I had just been talking about how things don't ever go the way that we plan them but they're good anyway.  The first few weeks have been hard but I think that it's made me all the more grateful for the chance I get to snuggle and hold my little baby now.  It's also given me a greater compassion for people who giv birth to babies who are life threateningly ill, that must be SO hard.  So I'm full of gratitude and love.....that is until I opened the first medical bill, YIKES.