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Premature child, fetomaternal bleed, low hemoglobin. Taken blood transfusions. Causes for condition?

My son was born 9 weeks early and had a fetomaternal bleed and was born with a hemoglobin of 2.2 and a hematicrit of 8 he had 3 blood transfusions and left the hospital at 35 weeks 5 days with normal levels he is now 4 months old 2 months adjusted and has a hemoglobin of 8 and is recieving only breast milk . What could cause this?
Asked On : Mon, 15 Oct 2012
Answers:  2 Views:  63
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OBGYN 's  Response
Hello there,
The fetomaternal bleed must have been severe enough to cause a drop in hemoglobin to 2.2 . It could have resulted from a traumatic delivery or an abruption but thankfully your baby recovered.
Since your baby was born preterm, you cant expect the baby to exhibit a blood profile similar to that of a term baby. All babies , whether term or preterm experience a drop in hemoglobin after their birth even if there are no complications. This drop in hemoglobin is seen at around 6-8 weeks of life and is known as physiologic anemia of newborn. The drop in hemoglobin is more in case of a preterm and the range is 7-9 gm/dl and in term babies it is 9-11 gm/dl/.
So dont worry. Although your baby was well transfused at the time of discharge, this is an expected phenomenon.
Take care.
Answered: Mon, 15 Oct 2012
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Pediatrician, Cardiology Dr. Pradeep Kumar's  Response
As your baby is premature this low hemoglobin level may be due to Anemia of prematurity. Most of the babies recover spontaneously from this condition after 4-6 months of age without any treatment. But other possibilities must be ruled out. So I would suggest you to consult your doctor and get a CBC, peripheral smear for hemolysis, reticulocyte count,Coomb's test and serum bilirubin level done for her, to rule out the other causes for anemia.
With regards
Answered: Tue, 16 Oct 2012
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