Bethany and Molly interview Dr. Timothy Bahr, a neonatologist with a specialty in neonatal hematology about all of your HDFN questions for newborns. Dr. Bahr patiently answers many of the common challenges and questions in neonatal HDFN care. This is an advanced discussion of neonatal HDFN. For a primer describing disease presentation, visit our neonatal episode in Season 1.
Questions answered in this episode:
What does it entail to prepare blood for a neonatal exchange transfusion?
When and how do you use erythropoietin/darbepoetin (ESAs)?
When does an HDFN baby need to be referred to hematology after discharge?
Heel prick versus blood draw from a vein, does it matter?
Is it ok to do transcutaneous bilirubin readings (with a small device on the skin instead of blood draw)?
When is a baby cleared from HDFN?
Why can’t we have the same neonatologist throughout a baby’s NICU stay?
How can a mother politely insist on regular laboratory testing for their newborn with HDFN?
How can a mother explain to the team at birth that it’s very important to get an immediate bilirubin check at birth (through cord or placenta if possible)?
What’s the difference between neonatal and pediatric hematologist?
Publications mentioned in this episode:
Delayed cord clamping in alloimmunization: https://www.sciencedirect.com/science/article/abs/pii/S2589933323003075
Iron overload in HDFN: https://scholarlypublications.universiteitleiden.nl/access/item%3A2881417/download#page=194
Systematic review on IVIG in the neonate for HDFN: https://fn.bmj.com/content/99/4/F325.short
Leiberman et al on IVIG in the neonate for HDFN: https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.18170
Darbepoetin to reduce the need for neonatal transfusion: https://cdn.clinicaltrials.gov/large-docs/26/NCT03104426/Prot_000.pdf
Publications by Dr. Tim Bahr: https://pubmed.ncbi.nlm.nih.gov/?term=Bahr_TM
Publications by Tim’s mentor, Dr. Robert (Bob) Christensen: https://pubmed.ncbi.nlm.nih.gov/?term=Christensen_RD
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