From Nurse to Mom

Anemia is a common condition in pregnancy and occurs when your red blood cells are low. The iron red blood cells hold oxygen, so when they are low, people will often feel tired, cold, dizzy, or weak. Often times, you lack color in your face or body and can have shortness of breath.

Difference in cell counts in normal vs anemic patients

Why do people have anemia in pregnancy?

When you are pregnant, you have a massive increase in how much blood you have in your body. This happens to provide enough oxygen, nutrients, and energy to your growing baby. However, this can cause your iron to drop.

Your diet also plays a part depending upon how you’re feeling. Moms will often have food diversions, which could make up for a lack of iron rich foods in your diet.

Other causes could be related to non-pregnancy related issues such as: sickle cell anemia or thalassemia, heavy periods, or bleeding ulcers.

Common symptoms:

Symptoms include:

Feeling tired

Continually cold

Dizzy or weak

Pale, dry skin

Short of breath

** if you are having any of these symptoms, it is best to call your healthcare provider.

How is anemia diagnosed?

Anemia is diagnosed by a blood sample called a complete blood count or CBC. This blood test is typically done on your first prenatal appointment and can be done throughout the pregnancy, if needed.

If your hemoglobin (part of your red blood cells) is low, your provider may start you on an iron supplement or recommend iron infusions through an IV.

Severe anemia is when your CBC shows a hemoglobin blood count of 6.5-7.9. At this point, your provider may recommend a blood transfusion.

How to increase iron levels at home:

**Always talk with a provider before starting supplements or medications.

Increasing iron rich foods, such as spinach, kale, red meat. Citrus fruits are important too, so oranges, tomatoes, peppers are also a great source of iron
Starting an over the counter iron supplement
Check your prenatal to see if you are already taking iron through this supplement

References & Resources:

https://my.clevelandclinic.org/health/diseases/23112-anemia-during-pregnancy

https://www.hematology.org/education/patients/anemia/pregnancy

https://www.nhlbi.nih.gov/health/anemia/pregnancy

Hope this helps!

One of the most confusing things I deal with at work is newborn jaundice. It is a complicated process to determine when a jaundice level is critical for a newborn and even more confusing when trying to break it down for new parents to understand. The simplest way I have been able to explain it is this: “all newborns have jaundice and there is nothing you can do to prevent it. Your powerful mama body has been the baby’s filtering system and now their little body has to wake up and filter itself. They do this with their liver and their liver is still small and learning how to do its job, so it takes some time for it to remove all of the jaundice (bilirubin). The baby gets rid of it by peeing and pooping. Therefore, we have to keep feeding the baby, as much as they’ll tolerate, to help their body’s get rid of the jaundice faster”

Here is what I’ve learned about jaundice in my years as a postpartum nurse:

Jaundice is a build up of red blood cells in the baby’s body. This is called bilirubin
These red blood cells circulate in their bodies, come to the surface of the skin, and make babies look yellow or orange in color
Jaundice starts from top and moves its way down through the infant’s body. So their face will often look more yellow before their arms, legs, and body
Age plays a huge factor: age of hours old the baby is at the time the jaundice levels are checked as well as how many weeks gestation mom was at the time of delivery
Jaundice levels can now be checked with a machine called a transcutaneous bilirubin device. This is a less invasive means of checking jaundice levels since we do not have to draw blood to get a bilirubin level
Jaundice can be hereditary, but not always. If a big sibling had jaundice in the past, we will check the new baby more closely
Babies get rid of their jaundice by peeing and pooping out the extra red blood cells. So nutrients and hydration are some of the most important factors in reducing jaundice levels
Not all babies need phototherapy (that blue light thing) and can get rid of the jaundice on their own through excretion
A baby will be lethargic, not wanting to eat (or eating poorly), and not having adequate pees and poops if their jaundice levels are rising
If a baby is not treated for jaundice and their levels rise to dangerous levels, it can cause brain damage and be fatal to the baby

So, why do we care about newborn jaundice levels?

As mentioned in #10, jaundice can be a life threatening condition if the newborn is not monitored and treated properly. The bilirubin can build up in the infants body, circulating to their brains, and cause “kernicterus, a type of brain damage that leads to movement problems and hearing loss” (AAP, 2022). A study done in 2022 states that 80% of newborns have some form of jaundice (link listed below) which makes communication between parents and providers essential. In addition, it is important that parents follow up with their baby’s doctor as recommended by the hospital. See the list below on when to be concerned enough to call your baby’s doctor.

When should I call the doctor?

Your baby’s skin turns darker yellow.
Your baby’s abdomen, arms, or legs are yellow.
The whites of your baby’s eyes are yellow.
Your baby is hard to wake, fussy, or not breastfeeding or taking formula well.

At the end of the day, almost all new babies experience some level of jaundice and most of them are able to get rid of this build up of bilirubin on their own. However, it is key that caregivers monitor and advocate for their newborns to ensure that they are safe and that the jaundice levels are trending downward.

References:

American Academy of Pediatric: https://www.aap.org/en/patient-care/hyperbilirubinemia/?srsltid=AfmBOoqm7V-qb22ghD_uSBZljdSHJ_ZgENRHoPpy2D9-UoVvxw7OEQYN

Parent Education Handout:

Jaundice and your Newborn: https://doi.org/10.1542/peo_document197

Link to a medical journal:

Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation – https://doi.org/10.1542/peds.2022-058859

I hope some of this helps you to understand newborn jaundice a little better. If you have questions, please feel free to ask me or look at the links above for information from some of the best sources. Let me know your thoughts on the topic. Did anyone have a baby who was jaundice? How was that experience for you? What can you share to help others understand this topic better?

Thanks for reading!