Newborns diagnosed with hemolytic disease of the fetus and newborn (HDFN) may experience symptoms associated with anemia and jaundice that influence their energy levels and sleep patterns. These symptoms can be gradually alleviated following effective treatment by phototherapy and in some cases, blood transfusions.
If symptoms of lethargy, floppiness, excessive fatigue and irritability continue despite treatment, it is a sign that the newborn requires additional treatment. Worsening jaundice could develop into life-threatening complications such as kernicterus.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy.
How does HDFN affect a newborn?
HDFN can occur in varying degrees of severity, ranging from mild to life-threatening and the overall health and well-being of the newborn is affected accordingly. Complications such as hydrops fetalis where the baby’s body swells with accumulated fluid as a result of severe anemia during pregnancy take a heavy toll on the newborn with HDFN.
Symptoms of anemia and jaundice in a newborn with HDFN may include:
- Pale skin
- Increased breathing rate
- Poor feeding
- Dark urine
- Rapid heart rate
- Yellowing of the skin, eyes and gums
- Irritability
- Fatigue
- Lethargy
- Floppiness
Learn more about HDFN symptoms and risks
Improving energy and sleep patterns in a newborn with HDFN
In most cases, a newborn with HDFN who receives immediate treatment will only experience short-term consequences. In addition to treatment, the maternal antibodies that attack the baby’s red blood cells, causing anemia and jaundice usually naturally disappear in the first 8 to 12 weeks of life.
Phototherapy is the standard of care for the treatment of jaundice in newborns. Jaundice or hyperbilirubinemia occurs when red blood cells break down and produce bilirubin in the blood. Phototherapy breaks down the bilirubin so that it becomes water soluble and easily eliminated from the baby’s body. Intravenous fluids can help flush out the bilirubin and keep the baby hydrated.
As phototherapy progressively treats jaundice in a newborn with HDFN, symptoms of lethargy, excessive fatigue and irritability will improve. If these symptoms do not improve or if they become worse, it is a clear sign that the anemia and resulting jaundice are not resolving, and an alternative treatment may be required.
Severe anemia will be treated by blood transfusion or an exchange transfusion which replaces the baby’s blood with elevated bilirubin levels with that of a blood donor.
When bilirubin levels in the baby’s blood stabilize and drop, you may notice a boost in the baby’s mood, energy levels and feeding.
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