Though feeding difficulties in newborns can be due to myriad causes, they may indicate fetal and neonatal alloimmune thrombocytopenia (FNAIT), if other symptoms such as lethargy, irritability, low blood platelet count, bruising and bleeding are also identified.
If your infant has already been diagnosed with FNAIT, you may want to watch them closely for any signs of feeding difficulties so you can consult with your care team right away.
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.
If a newborn baby has trouble feeding, this can indicate a more serious underlying problem and should always be investigated. It can be related to prematurity or a symptom of a range of conditions that affect the baby’s overall health, such as jaundice, birth trauma, sepsis, meningitis, heart defects, disabilities, abnormalities and FNAIT.
How can FNAIT lead to feeding difficulties?
If a newborn has FNAIT, they may have feeding difficulties for several reasons. These include:
- Intracranial hemorrhage in a part of the brain that affects sucking reflex and swallowing coordination.
- Small brain bleeds, which can cause a lack of oxygen to the brain, seizures and low muscle tone.
- Fatigue as a result of the strain and stress FNAIT is having on their system.
- Preterm delivery.
- Low platelet levels, which may cause weakness, fatigue, or discomfort in the baby’s mouth when feeding due to bruising.
If FNAIT is suspected, an urgent platelet transfusion may be performed to boost the baby’s platelet count and will be repeated until platelet levels rise. As platelet levels start to rise, the range of FNAIT symptoms will start to ease.
As the newborn begins to recover, symptoms such as fussiness, irritability, floppiness and poor feeding should start to improve. If this is not the case, it could mean neurological damage due to bleeding on the brain.
Managing poor feeding in newborns with FNAIT
A lactation specialist, whether in a labor and delivery ward or in the NICU, can provide support and practical advice on managing your newborn’s feeding difficulties. They are trained in supporting new mothers and preterm babies with health conditions, following medically complex pregnancies and birth trauma.
Here are some tips you may want to try if your newborn is having trouble feeding:
- Create a calm, stress-free environment
- Avoid expressing frustration
- Soothe and encourage your baby
- Support your baby’s head and neck
- Take regular breaks
- Feed on demand
- Use nipple shields to help with latching
- If bottle feeding, try different teats to help with weak sucking
- Ask for additional support when needed from your healthcare team.
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