Low Hematocrit with your little ones?

MrsRumpf · October 2011

Both my sons are now 34 weeks. They both have very low hematocrits 20.3 and 20.8.

Have your little ones had this too? If so, what did they do about it? My docs don't seem to want to give another transfusion because they'd have to be pulled off feedings. SO far all they've been doing is making sure they eat enough (to have enough protein) and getting their iron supplement.

Other ideas???

THANKS ALL!

bhilyer · October 2011

Hilyer was low several times. They watched it closely and he usually had another infusion. There was one time that he rebounded on his own.

It's fairly common. Preemies are small and they take a lot of blood from them, and their bodies can't replace it quickly.

I'm curious - why would they pull feeds if your guys get another transfusion? Our neos never pulled H's feeds.

adrielegorburu · October 2011

Madi had countless tranfusions in the NICU - but much like your boys, when she got older they would hold off longer and longer and give her crit a chance to bounce back on its own. eventually she didnt need anymore - they would also make sure she was eating and taking her poly-v/iron. Sometimes they need to pull out of things on their own - give them time and I'm sure the Neo's will step in with transfusion if they really need it.

kaylaaimee · October 2011

ITA w/the above posters.

once S got older they would wait longer to see if her crit would go up on it's own, which eventually it did.

They pulled her feeds sometimes during a transfusion as well, though I can't remember why.

OscarQ · October 2011

bhilyer:

Hilyer was low several times. They watched it closely and he usually had another infusion. There was one time that he rebounded on his own.

It's fairly common. Preemies are small and they take a lot of blood from them, and their bodies can't replace it quickly.

I'm curious - why would they pull feeds if your guys get another transfusion? Our neos never pulled H's feeds.

Same with Kevin. I remember them pulling the feeds while he was still tubed but once he was taking a bottle, they'd transfuse him and keep feeding him.

katie4253 · October 2011

We give poly-vi-sol with iron. They can do iron infusions too. I am sure if it gets any lower they'll be talking to you about what to do. It is super common, though.

cutcopypaste · October 2011

They use a medication called epogen instead of transfusions most of the time at our NICU. It actually stimulates the baby's own bone marrow to produce red blood cells instead of just giving them through a transfusion. It has worked for our daughter. It might be worth asking about.

njdcgirl · October 2011

My son had lots of transfusions during his NICU stay - I think 17 or so. As he got older they wanted to stop doing them, b/c at a certain GA their body is supposed to kick into gear and begin making/replenishing its own RBC and the transfusions delay that process from happening.

So, if your LO is doing ok otherwise they will just watch closely and hopefully soon they will be ok. My son kept having spells (big desats) which he couldn't pull himself out of and then he'd get another transfusion. He also got the epogen shots towards the end of his NICU stay.

mybb · October 2011

DS had 3 transfusions while in the NICU because of the fact that his hematocrit was low. I think it is the norm to get those when this happens, no?

snoopymom09 · October 2011

cutcopypaste:
They use a medication called epogen instead of transfusions most of the time at our NICU. It actually stimulates the baby's own bone marrow to produce red blood cells instead of just giving them through a transfusion. It has worked for our daughter. It might be worth asking about.

This is what our NICU did too. Colin had several transfusions early on, but once he got bigger/older, they decided to use the epogen instead. It worked for him.

schenkertobe · October 2011

Anemia is very common with preemies, because their iron stores don't build up until right before they are full term. Andrew was anemic when he was born- he got on transfusion. His hematocrit then slowly trended down again after that. But he wasn't symptomatic from it so they didn't transfuse him again. THey just gave an iron supplement, and I made sure I continued it after he left the NICU. The pedi rechecked his hemoglobin after discharge and it was fine.

MrsRumpf · October 2011

Thanks all! You are awesome!

I will be asking about some of these things. Both of their levels dropped again today so I will be all over it tomorrow!

Mrs. Alice · October 2011

Those are kind of low crits. Are they symptomatic? Have they checked their retic count? My guys got one transfusion when they were about 30 weeks GA. Right before we transferred hospitals at 33 weeks GA they checked crits and retic count - which checks to see if they are beginning to produce their own red blood cells. They were so they held off on transfusing them again even though they were borderline low.

My mom the NICU nurse explained that sometimes they don't transfuse if they are beginning to make their own RBCs and not symptomatic, in order for their bodies to get the message to correct the anemia on it's own. She also explained the reason why feedings are held during transfusions, I think it was because there is a increased risk of NEC.

They have continued on poly-vi-sol and neosure as a supplement.

Lavender444 · November 2011

snoopymom09:

cutcopypaste:
They use a medication called epogen instead of transfusions most of the time at our NICU. It actually stimulates the baby's own bone marrow to produce red blood cells instead of just giving them through a transfusion. It has worked for our daughter. It might be worth asking about.

This is what our NICU did too. Colin had several transfusions early on, but once he got bigger/older, they decided to use the epogen instead. It worked for him.

My DS was also given EPO. Between that and the Iron he got back to where he needed to be.

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