Key points about blood transfusions for newborn babies
- a blood transfusion gives your baby donated blood into a vein
- newborn pēpi may need a blood transfusion if they have anaemia or have lost blood
- donated blood is carefully tested to make sure it’s as safe as possible
What a blood transfusion involves
A blood transfusion is when donated blood is given to your baby. The blood goes into a vein through a small, soft plastic tube called a cannula.
A blood transfusion usually takes around 3 to 4 hours. Your baby’s healthcare team can give the blood more quickly or slowly if needed.
Reasons your baby may need a blood transfusion
Newborn pēpi, especially those born early, often have anaemia. Anaemia is when there are fewer red blood cells than usual.
There are several reasons why newborn pēpi may develop anaemia.
Normal fall in haemoglobin
After birth, the level of a hormone that helps the body make red blood cells drops. This causes a normal fall in haemoglobin. Haemoglobin is the part of red blood cells that carries oxygen.
This fall does not usually cause symptoms. In unwell or premature pēpi, haemoglobin may fall further. It may also stay low for longer, which can cause symptoms.
Breakdown of red blood cells
In some premature or unwell pēpi, red blood cells break down faster than usual and are not replaced at the same rate.
Blood loss
Some pēpi lose blood before or around the time of birth.
A baby may need a transfusion to replace blood lost during an operation.
Frequent blood tests
Pēpi who are unwell may need frequent blood tests to monitor their progress. Over time, this can contribute to anaemia.
Why red blood cells are important
Red blood cells carry oxygen around the body. The body’s organs need oxygen to work properly.
Anaemia is when there are fewer red blood cells than usual. Pēpi with anaemia may:
- look pale
- appear short of breath
- be sleepy
- not feed as well
Blood transfusions are generally very safe
Donated blood is tested to make sure it’s as safe as possible. In Aotearoa New Zealand, blood donors are unpaid volunteers who are carefully selected.
Blood transfusions are generally very safe, but reactions can sometimes happen. Most reactions are mild, and serious reactions are rare. The healthcare team will closely monitor your baby throughout the transfusion.
What happens during a blood transfusion
Before the transfusion
The healthcare team follows strict checking procedures before the transfusion. This is to make sure your baby receives the correct blood. Your baby must wear an identification band.
If you are with your baby, a nurse may ask you to confirm your baby’s full name and date of birth. If your baby’s name changes, tell your nurse so they can update your baby’s records.
During the transfusion
The healthcare team gives the blood through a tiny tube that goes into your baby’s vein. Each bag of blood can take up to 4 hours, but the healthcare team can give it more quickly if needed.
Most pēpi do not feel any different during a blood transfusion.
If your baby needs more than 1 transfusion, the neonatal unit may be able to use small portions of blood from the same donor. This helps limit your baby’s exposure to different donors. Practices may vary between neonatal units.
Tell your baby’s nurse if you have any concerns about your baby during the transfusion.
Blood from family members is not usually used
Blood donated by someone from your whānau (family) is not safer than blood from an unrelated volunteer donor. The risk of infection is not lower. Blood from relatives can increase the risk of some serious reactions.
For these reasons, family members do not usually donate blood directly for a baby.
Consent for a blood transfusion
Your baby’s healthcare team will explain why your baby needs a transfusion. They will ask for your consent whenever possible.
In an emergency, the healthcare team may need to give your baby an immediate transfusion to save their life. They may not have time to ask for your consent first.
You may decide not to consent to a transfusion. If the healthcare team believes your baby needs one, senior health professionals will talk with you about the next steps.
Platelet and plasma transfusions
Sometimes pēpi need a transfusion of a blood component other than red blood cells. Blood components are the different parts that make up blood, including red blood cells, platelets and plasma.
Your baby may need:
- platelets to help prevent or stop bleeding
- plasma to help their blood clot
Your baby’s healthcare team will explain why your baby needs the transfusion. Talk to a health professional if you have any questions or concerns. They are there to care for your baby and support you.
More information
The New Zealand Blood Service provides information for parents about blood transfusions for babies and children. This includes information about red blood cell, platelet and plasma transfusions.
Acknowledgements
Adapted from the leaflet: 'Pēpi/Babies Requiring a Blood Transfusion. Neonatal Services. Matatiki, Child & Youth Health, Waitaha Canterbury'.
