Late-onset anemia is when a newborn presents with the symptoms of a very low red blood cell count at least one week after birth, and it most commonly presents two to 12 weeks after birth.
In newborns with hemolytic disease of the fetus and newborn (HDFN), it occurs as the maternal antibodies continue to attack the newborn’s red blood cells. Close monitoring at home is required, as the complications of severe anemia can be life-threatening.
What is late-onset anemia?
Late-onset or delayed onset anemia is anemia that occurs between 2-12 weeks of life. In HDFN, it can present regardless of the type of incompatibility (Rh, ABO, Kell, etc.) and has been reported in 71-83% of newborns with HDFN due to Rh. According to data, incidence is highest among newborns who received an intrauterine transfusion during pregnancy.
Anemia is a very low red blood cell count, which reduces the oxygen transported around the body. When the body doesn’t receive enough oxygen, the body becomes fatigued, and the internal organs don’t function correctly. The heart can be impacted, eventually leading to heart failure, if untreated.
Why does late-onset anemia occur in HDFN??
In HDFN, the mother’s antibodies remain in the newborn’s bloodstream for several weeks and they can continue to break down the baby’s red blood cells during this time. The newborn cannot produce its own red blood cells at a fast enough rate to replace those being destroyed, leading to anemia.
Ways of monitoring late-onset anemia at home
Anemia can sometimes be hard to detect in newborns, especially in mild cases. However, it. Important to stay vigilant, as it can progress quickly, and the consequences of untreated severe anemia can be life-threatening. Close monitoring and early detection are essential for urgent treatment and the best outcomes.
The common signs of anemia to watch out for include:
- Fatigue, sleepiness or low energy
- Pale skin, gums or lips
- Cold hands or feet
- Poor feeding or tiring easily during feeding
- Fast heartbeat
- Rapid breathing
- Fussiness or irritability
Alert your healthcare team if you notice these symptoms. Your baby may require urgent care, such as a blood transfusion if their condition worsens.
As part of follow-up care with your pediatrician or healthcare provider, regular blood tests may also be scheduled to check red blood counts.
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