Newborns with fetal and neonatal alloimmune thrombocytopenia (FNAIT) may need to spend time in the neonatal intensive care unit (NICU) if they are born prematurely and/or require specialist care.
FNAIT symptoms may affect breastfeeding if the baby is preterm or has a heavy symptom burden. Other feeding options may be required to ensure the infant is receiving enough fluids and nutrients.
What is FNAIT?
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare but serious condition that affects 0.1% of pregnancies in which a pregnant mother’s immune system produces antibodies against the platelets of her fetus. This occurs when a fetus inherits platelet antigens from the father that are not compatible with the mother, typically involving a protein called human platelet antigen (HPA). The mother’s immune system recognizes the fetal platelets as foreign, attacking and destroying them, leading to low platelet levels (thrombocytopenia) in the fetus or newborn.
The importance of extra nutritional support for FNAIT-affected newborns
Newborns with FNAIT may have a lower birth weight and be potentially nutrient and vitamin deficient. This can be due to FNAIT-related complications during pregnancy and intravenous immunoglobulin (IVIG) treatment. Following delivery, extra nutritional support is required to boost growth and development. Breastfeeding is recommended for babies affected by FNAIT, but if it is not possible, formula feeding is a good alternative.
There is no risk of maternal antibodies passing through the breastmilk and attacking the newborn’s platelets.
Learn more about FNAIT treatment and care
The benefits of breastfeeding in FNAIT newborns
Breastmilk is considered to be the best source of nutrition for newborns from birth and for the first six months of life. Newborns who are preterm and/or suffering from FNAIT can benefit from the rich nutritional support provided by human breastmilk.
Breastmilk is full of nutrients, such as fats, proteins, carbohydrates and vitamins, as well as immunoglobulins, lactoferrin and cytokines. It is easier for a preterm or sick baby to digest and it protects the baby’s gut from necrotizing enterocolitis and intestinal infections. Additional protection has been shown against respiratory tract infections, urinary tract infections, allergic reactions, acute otitis media and hospital admissions. It also improves cognitive development and reduces the risk of childhood obesity.
Newborns who are preterm, with a low birth weight and FNAIT symptoms such as a low platelet count, bruising, bleeding under the skin called petechiae and purpura may have trouble breastfeeding. It is worth persisting because the skin to skin contact is an important bonding experience for the mother and baby, and it comforts the baby and reduces stress.
Breastfeeding or feeding the newborn with expressed breast milk in a bottle is the best choice for ensuring a baby affected by FNAIT receives the nutrients and vitamins it needs to catch up on growth and development. Human breastmilk also strengthens immunity, boosting the newborn’s overall health and response to FNAIT treatment.
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