Positive Coombs Test in Newborn – Do You Need to Worry?

Medically Reviewed By
Dr. Gunjan Baweja (Paediatrician)
View more Paediatrician Our Panel of Experts

The nine months of pregnancy, followed by labour and delivery, are surely challenging, but they are nothing in comparison to being a mother. Taking care of a baby and ensuring that he stays healthy and happy becomes the main goal of a mother’s life. And if your newborn baby gets detected positive for the Coombs test, it will add to the existing worries and might leave you exhausted while you help your baby recover. A human body is complex, and therefore, many medical complications can affect your newborn baby. But if you don’t let panic take over, you can deal with it. Read on to know more about this condition in newborn babies.

What Is Coombs Test?

Our immune system produces a protein in the form of antibodies, which helps in protecting our bodies from different kinds of infections and ailments. However, sometimes these antibodies work against the body and start killing the red blood cells. Hence, your doctor may advise you to undergo antibody screening test during pregnancy to check if your antibodies are attacking the red blood cells in your body. If the doctor suspects that you have low red blood cell count, he may suggest a blood test known as Coombs test. This test is further classified into Direct Coombs Test and Indirect Coombs Test.

What Does a Positive Coombs Test Mean in a Newborn Baby?

If your baby undergoes a Coombs test and the test result is positive, it may indicate that there are chances that the mother’s blood got mixed up with the baby’s blood. This may occur if there is a disparity in the Rh factor of the blood of the mother and the baby. If the mother is Rh-negative and the baby is Rh-positive or vice versa, certain complications may arise if the blood gets mixed up.

In order to rule out the presence of any mixed-up blood, Coombs test may be performed on newborn babies by either taking blood from the umbilical cord (just after birth) or directly from the baby.

What Causes a Coombs Test to Turn Positive in a Newborn?

The main causes that may reflect a positive Coombs test include the following:

  • If the mother and baby have separate blood groups, the mother’s blood sees the baby’s blood as an alien element in the bloodstream and thus produces antibodies against it to kill it. These antibodies may get passed in the baby’s blood and show a positive result in a DAT or direct antiglobulin test.
  • The coombs tests may show positive results when an Rh-negative mother gets Rho(D) immune globulin shot and the traces of which may get passed on to the baby’s blood.

What Problems Can Coombs Positive Babies Face?

If your baby is adjudged Coombs positive, he may suffer from either of the following issues:

1. Anaemia

Anaemia is a condition that may occur when there are fewer red blood cells in the body than the required amount. Coombs positive babies may have a reduced red blood cell count in their body, which can make the baby sluggish, lethargic, sleepy, feed poorly and many other complications. Such babies may sometimes require nutrition through an IV. It is not necessary that coombs positive babies will be anaemic; however, it may increase their chances of having anaemia.

2. Jaundice

Though most newborn babies have certain degrees of jaundice that subsides on its own in most cases, babies who are detected coombs positive may be at a higher risk of developing jaundice. This condition increases the bilirubin levels in the baby’s body, and higher levels of bilirubin may put your baby at the risk of experiencing brain damage and other health complications.


How to Take Care of a Coombs Positive Baby

Babies are delicate, and if your baby is Coombs positive, he requires extra care. Here’s how you can take care of him:

  • It is important that you pay heed to breastfeed the coombs positive newborn because breast milk is loaded with antibodies that may help your baby fight the symptoms of jaundice.
  • The doctors and other medical teams may keep your baby under observation and monitor your baby’s progress closely.
  • Your baby may be required to undergo regular tests to monitor his anaemia and jaundice.
  • If your baby is suffering from severe jaundice, your doctor may advise for photo-therapy. Photo-therapy is a procedure that requires your baby to be placed under a special light bulb that may help in breaking down the bilirubin and thus curing the symptoms of jaundice.
  • Sometimes your baby may suffer from a severe case of anaemia or jaundice, which may require extensive medical procedures and treatments. In case such a situation arises, you may be told about the procedures and their implications, too.

Are There Any Long-Term Complications for Coombs Positive Infants?

As soon as you deliver your baby, there is no more mixing of blood that may happen. Also, as per the severity of your baby’s condition, the doctor will keep your baby under observation and offer the required treatment. Slowly and gradually, your baby’s blood may get rid of the alien blood and start making new blood cells. In most cases, coombs disease in newborns does not cause any long-term complications.

When Can a Coombs Positive Newborn Go Home?

You can take a coombs positive newborn home at the usual time. But you will be required to visit the hospital for a checkup in a few days to know if your baby is recovering well or not. However, if you notice any changes in your baby’s complexion, or if your baby’s face starts looking paler, this could mean that his anaemia or jaundice may be becoming severe. In such cases, your baby may be monitored closely, or you may be required to stay in the hospital if your baby’s condition becomes more critical.

There are many medical complications that may affect the health of a newborn baby. It can be overwhelming for the parents; however, you must trust your doctor and work as a team for the speedy recovery of your baby. Most cases of coombs positive babies may not exhibit any severe complications, and thus can be effectively managed by proper care and medical treatment.

Also Read: Newborn Hearing Screening Test

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