The pregnancy journey may end with delivery, but a brand new journey is just beginning. For any mom, but especially those who have a newborn with a medical condition like hemolytic disease of the fetus and newborn (HDFN), this time is exciting, but it can also be filled with uncertainty.
Depending on your baby’s health, well-being and gestational age at delivery, you could experience an extended stay in the hospital. Your baby’s growth, development and successful treatment of HDFN symptoms will be assessed before discharge is possible. Then, the real adventure begins.
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 (RhRh factor A protein or antigen found on red blood cells. When an Rh-negative mother carries an Rh-positive fetus, her immune system may make antibodies that attack the fetus' red blood cells.) factor (Rh-positiveRh-Positive A blood type trait that means your red blood cells have the Rh(D) antigen. or Rh-negativeRh-Negative A blood type trait that means your red blood cells lack the Rh(D) antigen.) during pregnancy. Numerous antibodiesAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. to RBC antigensAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. can be linked to HDFN, such as those from the ABO and Rh blood groupBlood group A classification of blood based on inherited markers found on red blood cells. The ABO and Rh blood groups are most common in HDFN. systems.
The first days at home
Being home with your baby following a challenging pregnancy and birth experience can be both exciting and overwhelming. After the constant support of your medical team, you may feel a little anxious at finally going it alone. To help relieve this pressure, plan to have the support of family and friends in the first few days, if possible. Your recovery and well-being are essential to caring for your new baby, so be sure you find time to rest.
All new mothers receive newborn discharge information as they leave the hospital with their baby for the first time. This will cover topics such as umbilical cord care, breastfeeding, bottle feeding, sleeping, wet diapers and stools, dressing your baby and managing a sick baby, just to name a few.
Post-discharge, most HDFN-affected babies will come in for follow-up visits for several weeks or even months, to ensure that symptoms of anemiaAnemia A condition that occurs when the body doesn’t have enough healthy red blood cells to carry oxygen to its tissues. In HDFN, anemia occurs when maternal antibodies destroy fetal red blood cells. or jaundiceJaundice A common symptom of HDFN, jaundice is caused by excess bilirubin and is characterized by a yellow tint to the skin or eyes. don’t reoccur. Take advantage of these appointments to ask any questions that may come to you as you settle in at home.
Finding your new normal
Adjusting to life with a newborn means new routines and new priorities for you and your family. Newborns often sleep a lot to start with, they also cry to communicate their needs. As you learn to interpret this baby language, spend time cuddling and bonding with your baby. He or she is also adjusting to a new normal, after the excitement or stress of their delivery.
After the anxiety of an HDFN-affected pregnancy and birth, you may feel very protective of your newborn. This is normal, and while newborns are fragile, try to relax into motherhood, trust your instincts and enjoy time with your baby.
As soon as you feel ready, take your baby out of the house. Start off small – get some fresh air and go for a short walk. Then expand your comfort zone by visiting family or going to the supermarket. It might take some planning – dress your baby for the weather, pack a diaper bag, anticipate your feeding schedule – but the change of scene will be good for both of you.
