Childbirth the second time around went much smoother and quicker than the first. I felt more confident in myself and my abilities to take care of a newborn. We were anticipating a much easier time since we knew what we were doing.
In the hospital, the baby was latching and eating great, calm and alert, and we were able to have our whole family together when our daughter came to visit. We were getting ready to take our precious new baby home and spend the next few weeks getting acclimated as a family of 4.
The morning of day 2 in the hospital, the pediatrician came in to clear us and give us the summary of all the baby’s blood panels and preliminary health screens. He told us that everything looked good, but his bilirubin was a little elevated.
Our first baby had elevated bilirubin, but not significant enough for phototherapy, so I wasn’t too worried. She looked a little yellow the first week or two, but the levels went down on their own and we just needed to go for one extra blood work to confirm that.
The pediatrician told us to put him close to the window in the hospital and that he would take the test again in 8 hours to check if the levels have gone up or down. There ended up being a significant increase after that time, so he ordered that our baby go under the light for phototherapy.
They assured me that the light will bring the levels down and he would stay under it in the nursery through the night. They brought him out every 2.5-3 hours to nurse and he was doing just fine.
It was very upsetting that I couldn’t be with my newly born baby for the whole night, but I knew it was what was best for him. We hoped that his levels would go down enough by morning because the next day was our discharge day.
I was still not too worried because I know jaundice is fairly common and disappears on its own within a few days. I was confident that being under the photo light would bring the levels down enough to a safe range.
The morning of day 3 came and we were very anxious to go home. I couldn’t wait to get out of there! We had planned to leave the hospital around 11am when his phototherapy was complete and we just needed the doctor’s all clear.
After this blood test, the doctor informed us of the news that his levels were still too high (11.4) and that a few more hours of light therapy were required. So instead of leaving at 10am that morning, we were stuck in the hospital for another half day while our baby boy got additional treatment away from our loving arms. We started to wonder if the jaundice would ever leave his body.
That whole day I spent alone. Missing my newborn, missing my toddler, and not even having my husband to keep me company because he had to go home and take care of our daughter.
We assumed we were going to still leave on our discharge day, just later (around 6pm). Not a chance. Unfortunately, the levels had gone up even higher to 13.1. I was so confused and worried why the levels would go up when he was under the light all day. So I had to spend another night alone while the baby was under the light. The only time I was able to see him was during those feedings every 3 hours.
Why I began supplementing with formula
The doctor and nurses both informed us that jaundice makes the baby very lethargic and could have difficulty latching and feeding. Eating more is what would help the bilirubin levels go down and get it out of his system quicker. So it was suggested to increase the frequency of feedings, as well as supplement with formula.
The nurses knew I wanted to breastfeed, so they weren’t too direct about suggesting formula. They hinted at it but I knew what they were trying to tell me. The only way the bilirubin can leave the body is through the skin and urine. That’s why sunlight helps when it penetrates the skin and the more the baby pees and poops, the faster it will come out. Formula can increase the production of urine and feces, therefore making it come out of the body quicker and ultimately reducing the levels to an acceptable point.
As I was starting to get nervous about the high levels of bilirubin and the baby getting more and more lethargic as the hours passed, I agreed to letting the nurses assist me in giving the baby some formula. We were willing to do whatever it took to help our baby get healthier again.
I was a little concerned about whether he wouldn’t want to breast feed anymore since the bottle is easier, but he was able to go back and forth between nursing and bottle with no problem.
For each feeding I planned to breastfeed before we gave the bottle to stimulate my milk production and make sure he didn’t forget how to latch. However, suckling from the breast is much harder for a newborn than taking a bottle. Since the jaundice makes them much more fatigued, once I would put him on my breast, he would just fall asleep and barely eat anything. Therefore, we ended up giving him the bottle for all of the feedings.
My husband gave the formula when he was there to give him a chance to bond with the baby. I didn’t pump while in the hospital because my milk hadn’t come in yet. Just getting him to latch on every feeding would stimulate my breasts enough and that worked out just fine when my supply eventually came in.
We woke up to good news from the lab results that the levels had gone back down to 11.9 and we were finally cleared to leave. The doctor assured us that once the levels start dropping they shouldn’t go back up. I was never even told how bad it could really get!
Bringing him home
The days that followed were nothing short of stressful and worrisome. He became increasingly leathargic and so difficult to arouse. We could have thrown him up in the air and he wouldn’t have even budged. That’s how bad it was getting.
It was torture to feed him. To stimulate him enough to stay up for more than 5 minutes was nearly impossible. We tried everything to arouse him: cold washcloth, stripping him down, ice cubes along his body, moving him around in the air, and changing his diaper. Unfortunately, nothing worked.
We were told to feed him every 2.5 hours because the only way to get rid of bilirubin is through urine and stool so we needed him to pee and poop as much as possible. He had a good number of wet and soiled diapers, but it was still not helping.
We placed him near a window for most of the day, laying out in just a diaper so he could absorb as much sunlight as possible. Unfortunately it was a very cloudy week so it didn’t seem like that was helping much either.
The exhaustion was getting to us because even though he was sleeping well at night, we still had to wake him to feed. He was even more lethargic at night and it was impossible to get him to take an ounce out of a bottle. Since it took about an hour for a feeding because of all the stimulation, I would have to wake up an hour after that to feed him again. This is when I started pumping every time my husband gave him a bottle of formula to keep my supply up.
Days 5 – 7
We were taking him to the lab to get his blood drawn once a day. A few times they just did a foot prick which was fine and no tears. Two times they did a regular blood draw through his cephalic vein in the arm. That was torture for him and us. Thank God my husband was around because I couldn’t stay in the room with him while he was screaming. I just felt so helpless that I couldn’t make him feel better.
After each blood test, we were anticipating it going down since our doctor assured us that it shouldn’t spike up again. However, it continued to go up. Day 5’s results were 15.7, day 6 was 16.6, and day 7 was 16.4.
Around these days, the concerning number is 21. Although we were getting close, we were still in a fairly safe zone. I also learned that even when it is at that concerning level of 21, that’s still WAY BELOW where it could cause any permanent damage. This is just the threshold that the doctors need to monitor it at so it doesn’t get any higher.
I asked the doctor what the options were and if we could bring him back to the hospital for more phototherapy. The doctors assured me that his levels weren’t high enough to warrant that, but I was basing it off of how my son was acting and not just a number.
Being barely responsive to stimulation or movement, I wanted to get him treatment. It didn’t seem like the doctors wanted to be as proactive as I wanted them to be. They just advised us that if it got any higher, they would admit us back to the hospital for phototherapy, but level 16 at 5 days old was JUST under the concerning level. Even though it seemed like he was barely eating, he was continuing to gain weight which was a relief.
There were times where his little body just looked so lifeless. On night 7, his skin got so pale/yellow and he didn’t even look like he was alive. I had to check his breathing several times and this was starting to freak me out. We ended up bringing him to the emergency room that night because we hadn’t gotten the results of that day’s test and I was worried that the number had gone into dangerous levels. We got better news that night that the level stayed the same which is actually good! The older they get, the number can bro up and they would still be in the clear.
Days 8 – 10
We finally started getting better news on day 8. The levels were dropping and at THIS point, if they start to drop, they are in the clear because they can’t go up from here. Day 8 was 14, day 9 was 12, and day 10 was 9. Single digits! We were so relieved.
At this point he started to get a little less yellow and a little less lethargic. It took a few more days, but he was finally back to himself again and we couldn’t be happier!
What could have caused it
Infant Jaundice, characterized by yellowing of the skin, is caused by an increase in bilirubin in the liver. Read more about the temporary condition here.
Our baby had a small hematoma (red bruise) on his head from coming through the birth canal. The doctor informed us that this could have been a cause. A hematoma can add more red blood cells that their little body can’t handle. It could have also been the fact that my blood type was O+ and the baby was A+ and when these bloods mix at delivery, it can cause increased bilirubin levels.
We’ll never know what truly caused it, but are so thankful that he got better quickly.
Levels by day for reference
- Day 3: 11.4 (morning), 13.1 (night)
- Day 4: 11.9
- Day 5: 15.7
- Day 6: 16.6
- Day 7: 16.4
- Day 8: 14.2
- Day 9: 12.6
- Day 11: 9.4
I thought I had it all together because it was baby #2, but I was so wrong. Every child brings new experiences and always new worries to light. Everything ended up working out in the long run, so I wish I could have made myself not worry so much, but that’s what motherhood is all about.
If I have any advice for you moms struggling with this situation, it’s that it DOES go away and will get better. The early signs of yellowing skin and fatigue are just warning signs that we should get help before it actually turns worse. As long as you’re able to get your baby fed and they are continuing to gain weight, their body will tackle the condition quickly.
In the most extremely rare cases does it cause brain damage and that’s when it gets to very high levels, which are WAY HIGHER than the levels when doctors initially get concerned. It’s just something that you have to ride out for the first week or two after birth and then it will resolve itself on it’s own.
Jaundice is not something that will stick with them. It’s merely a temporary condition due to their livers not being fully functional yet because they are so young.
Related Posts: 13 Ways to Play With and Stimulate your Newborn
Related Posts: How to Survive the First Few Months with a Toddler and a Newborn
Related Posts: How to Establish Healthy Sleep Habits for your Baby