A newborn affected by hemolytic disease of the fetus and newborn (HDFN) will most likely suffer from anemia and jaundice and may also have difficulty feeding.
Jaundice is caused by a buildup of bilirubin in the blood and is dangerous to the baby if it is not eliminated or if bilirubin levels continue to rise. A newborn will need plenty of fluids – breast milk or formula – to help the liver break down the bilirubin and eliminate it via their stools. However, complications including prematurity and symptoms of HDFN may mean that breastfeeding is not an option and nutrition is delivered in other ways.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell (RBC) 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. Numerous antibodies to RBC antigens can be linked to HDFN, such as those from the ABO and Rh blood group systems.
Newborns with HDFN are often born prematurely
Newborns with HDFN are often delivered prematurely, with an average gestational age at birth of 34 to 36 weeks. Preterm babies require specialized care, which they often receive in the neonatal intensive care unit (NICU). Babies with HDFN are at risk of serious outcomes if their anemia and jaundice are not quickly and effectively treated.
Premature birth and HDFN can both affect the newborn’s ability to feed. In preterm babies, this may be because the digestive system is not yet fully developed, but it can also occur if the infant cannot yet swallow and suck. This will rule out breastfeeding, and the baby will require either an intravenous line into the bloodstream to deliver much-needed nutrition or a tube into the nose or mouth that delivers formula.
HDFN causes fatigue and irritability, and the high levels of bilirubin in the blood can affect the baby’s sucking reflex. In addition to prompt treatment of HDFN symptoms, for babies affected by HDFN, adequate nutrition and hydration is essential to their recovery.
Breastfeeding babies with HDFN
While the benefits of breastfeeding for babies are undeniable, recent research has found that it may not be as beneficial in newborns with HDFN. A study showed evidence that the mother’s anti-D antibodies that attack the baby’s red blood cells by crossing the placenta during pregnancy may also be transferred via breast milk. While further research is required, breastfeeding may be a factor in cases where the baby’s bilirubin levels continue to rise despite treatment.
