Andrea and Nathan Lively were looking forward to May 18, 2009, when their twin baby girls were due to be born. Andrea’s pregnancy had gone smoothly, with trouble-free check ups and no indication of any problems. She continued to work at her job with the Oregon Department of Forestry and went to work as usual on Thursday, February 5. But later in the day when she started having what she realized were contractions, Nathan rushed her to Sacred Heart at RiverBend. They arrived around 7:30 that night, and even though the doctors tried to slow down the babies’ birth, the twins did not cooperate. Keira and Kyla arrived at about 10:30 that night and were immediately taken to the neonatal intensive care unit. They both weighed just over one pound apiece and were unable to breathe on their own.
According to one of their doctors, Dr. Igor Gladstone, that in addition to being very small, the babies were sickly and needed to be on ventilators. To monitor their progress, doctors had to draw blood from them on a daily basis. Unfortunately, their bone marrow was unable to keep up the red blood cell production necessary for these daily blood tests and their hematocrit levels dropped to dangerously low levels. By the 2nd week of their lives, their doctors realized the babies needed blood transfusions to prevent life-threatening anemia.
Both little girls received a transfusion of blood collected by Lane Blood Center from special “baby donors.” These are people with O Negative, CMV Negative blood. [CMV is a common virus which causes a mild cold in children and adults. However, CMV can be passed through blood transfusion and can cause more serious infections in premature babies. All blood used for premature infants is CMV negative; that is, it is donated by people who have not had CMV infections.] Because of their tiny size, the babies received small amounts of blood, probably no more than two or three tablespoons each. However, they showed improvement once the new blood was infused.
After Keira and Kyla spent 116 days in the hospital, Andrea and Nathan were able to take them home where they are continuing to grow and flourish.
Anemia in The Newborn
Every baby becomes anemic 4 to 8 weeks after birth. This is called ‘physiologic’ (or normal) anemia. In adults, red blood cells get old and break down but the body makes new red blood cells to maintain a normal red blood cell count. Babies cannot make new red blood cells until they are 6 to 8 weeks old, and so they cannot replace the lost red blood cells and they become anemic. Once the baby starts making new red blood cells, the red blood cell count gradually returns to normal. Most babies do not have any symptoms from this natural process and do not need treatment.
Premature babies become anemic sooner than full-term infants because they start out with fewer red blood cells. They also lose blood from frequent blood tests. Many premature babies become anemic before their body can make red blood cells and they may need a transfusion of blood. The smaller a premature baby is, the more likely she will need one or more blood transfusions in the first 2 months of life.
–Patricia Bromberger, M.D., neonatologist, Kaiser Permamente, San Diego, CA