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Blood Transfusions in the NICU

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Updated July 01, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Blood transfusions can save the lives of premature babies.

Blood transfusions can save the lives of premature babies.

Image courtesy of Zigy Kaluzny / Getty Images
Question: Blood Transfusions in the NICU
My baby's doctor says that she needs a blood transfusion, but I'm worried because I've heard they can be risky. What do I need to know before I sign the consent form?
Answer:

What is a Blood Transfusion?

A blood transfusion is a procedure where blood is given to a patient through an IV line. To most people, a blood transfusion refers to giving red blood cells that carry oxygen. Red blood cells can be given as packed red blood cells or as whole blood. Other individual parts of blood are also sometimes given for different reasons, such as platelets that help stop bleeding.

Why Might a Baby Need a Blood Transfusion?

In the NICU, babies may be given a red blood cell transfusion for several reasons. The blood may be needed in an emergency to replace blood loss from anemia, which without treatment can lead to shock or death. More commonly, the blood is transfused to treat symptoms caused by anemia, like apnea.

What Are the Risks of a Blood Transfusion?

Because donor blood is screened so carefully, blood transfusions are very safe. Blood-borne diseases can be transmitted through blood transfusions, but the risks are very low. The risk of getting HIV from a blood transfusion is about 1 in 1.8 million; the risk of hepatitis B is 1 in 171,000. Thanks to modern blood banking techniques, blood from a single donor is stored for a premature baby until that blood is used up or expired. This has lowered the risk of blood transfusions for preemies by reducing the number of donors a baby is exposed to.

Transfusion reactions are another risk of blood transfusions. However, transfusion reactions are extremely rare in newborn babies, especially premature babies.

What Are the Benefits of a Blood Transfusion?

When they are given for shock or severe blood loss, blood transfusions can save a baby's life. Other benefits of a blood transfusion may be less obvious, and may include:

  • Better feeding
  • Less respiratory distress
  • Less apnea
  • Less trauma to the brain
  • Earlier NICU discharge

Can I Donate My Own Blood for my Baby?

If you and your baby are the same blood type, you may be able to donate your own blood for transfusion to your baby. This type of blood donation is called a directed donation, and may be an option if:
  • The transfusion is not an emergency: It takes a week or two to prepare blood for transfusion, so directed donation cannot be used in emergency situations.

  • You are not a postpartum mom: You must wait 6 to 8 weeks after having a baby before you can give blood.

  • You are a healthy adult: Blood donors must be over age 17 and weigh at least 110 pounds. They must be healthy and must pass a health history exam.

  • You are willing to pay for lab work: If you are interested in directed donation, you must pay to have your blood tested and drawn. Most insurances will not cover additional costs associated with directed donation.

Sources:

Bell, EF. Nov. 2008. When to transfuse preterm babies. Arch Dis Child Fetal Neonatal Ed. 93(6) F469-F473.

Von Kohorn, I. & Ehrenkranz, R. March 2009. Anemia in the preterm infant: Erythropoietin versus erythrocyte transfusion - It's not that simple. Clinical Perinatology. 36(1):111-123.

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