Thursday, May 01, 2008

Maggie's phototherapy

Maggie didn't LOVE the Bilibed, but she settled pretty quickly in it, though she'd rather be swaddled and held, and it was so much more comfortable for her than a biliblanket or bank of lights and blindfold would have been. Phototherapy for neonatal jaundice uses UV light to help break down the bilirubin that the baby's liver can't clear on its own. My mom says that a nurse discovered it by accident; she noticed that the jaundiced babies near the window did better than the jaundiced babies who weren't. (I don't know the whole story but that's what my mom says.) With my first two that's just what we did, we put them by the window and nursed frequently. Unfortunately, Maggie's jaundice was more severe and her bilirubin levels were higher. (Thankfully, they only had to stick her once a day, not two or three times like they once would, in between they used a jaundice meter that works on light instead of a blood draw to estimate her level and make sure it wasn't rising. Another new purchase since last time I was there.) The way the ABO isoimmunization jaundice works is this-- basically, I'm genotype OO, my husband is AA (we are pretty sure) and our kids are therefore AO, with each pregnancy I react to the baby's blood type by producing antigens which are passed to the baby. It's trying to deal with the antigens that causes all the problems. Unfortunately, it's likely that every baby will have some degree of jaundice, and since the levels seem to get higher each time, it's likely that future babies may require phototherapy as well. So I'm glad the hospital has the Bilibeds and my babies don't have to suffer the other kinds of bililights!

Since she was much more comfy with some confinement of her legs, one of the nurses sweetly showed me how to roll and tuck a blanket or two around them to provide more of a "swaddled" feel in the Bilibed (which is a mesh mattress over a lamp that sits in the hospital bassinet instead of the bassinet mattress, and then is covered with a special kind of blanket-cum-sleeper that snaps on to the mesh mattress and has sleeves, a zip-up place for the legs shaped like a sleep blanket's "sack", and velcro closure up by the neck for a better fit. Oh, and a little duck on the top velcro closure.

Since she has such strong suck needs and I couldn't nurse her longer than just what she needed to empty the breast because she needed the lights, Maggie got very fond of her paci. (That's the RazBaby Keep it Kleen paci, btw; they really do what they're advertised to! She drops it and it snaps shut! We love 'em!) She got used to the routine; I would see her waking, change her diaper, nurse her, burp her, put her back on the lights (usually with a spit pad under her head, she's a spitty baby) and then give her her paci and sometimes sing to her and/or pat her tummy to settle her until she calmed down. Then we'd go back to sleep, usually.

The only time I could hold her during the phototherapy was while I nursed and burped her. So I made the most of it. I had Jeff burp her so he got some holding time, too, if he was around, and would let the kids help by tickling her feet and kissing her head to keep her awake, and Emma even helped Jeff give her a bottle when she needed a little supplementation. But most of the day it was just me and her in a room with the lights.

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