ABO incompatibility between mother and child equals jaundice

I am B+ and my wife is A+. Our first child was not screened for her blood group, which was surprising, especially considering that this test is not too expensive and would be informative for parents and children. The hospital told us that such test is only applicable if we asked for it or if the baby is G6PD deficient.

Our first child had jaundice and it took us some time before her bilirubin level was reduced. At that time, we thought that her jaundice must have been a common case among Asians.

Then, when it was our second child, we explicitly asked for his blood group to be determined. Our boy was AB+. Similar to his older sister, our boy had jaundice and it was not manageable for us when we brought him home. As we opted for full breast feeding, my wife's milk supply was initially low (colostrum) and it did not provide sufficient fluid and material for baby to pass enough stool or urine to cleanse his system of bilirubin. We brought our baby out for the morning sun for the purpose of reducing his jaundice, but that effort was insufficient.

A visit to a polyclinic to have our boy tested showed that his bilirubin level was high (at 292 micromol/l). The doctor recommended admission for phototherapy. It took our baby 4 days for his jaundice to subside under the phototherapy!

Our insistence on testing for our baby blood type allowed the pediatrician to suggest that our baby's jaundice could have been due to ABO incompatibility. We wondered, if we didn't insist on the blood test, would the pediatrician have been able to form such diagnosis? If ABO incompatibility is a common problem that contribute to jaundice in baby, why doesn't the hospital provide compulsory blood group test, so that parents' can be informed of next course of action?

Just a thought

Note

• ABO incompatibility in mother and child is due to the traversing of mother's antibody to her baby's circulatory system. In our case, my wife is A+ (which means she has antibody against antigen B). When the antibody gets into baby's circulatory system, it will attack baby's red blood cells that have both antigen A and antigen B on them. This causes increased lysis/destruction of babies red blood cells and hence increase in bilirubin level (intermediate product of the cell turnover).
• Abnormal increase in bilirubin level in babies have been associated with mental retardation. That is why we are compelled to send our son to the hospital for phototherapy when the doctor told us his bilirubin level was high.
• How blue light reduces bilirubin is by solubilizing the chemical in the body so that it can be cleansed from the system via passing of water and motion. See Bilirubin by Wikipedia.