Unseen Battles, Unmatched Strength: HDFN in Kenya

Unseen Battles, Unmatched Strength: HDFN in Kenya

Rose and Katie return for an intimate discussion with Bethany and Molly about the realities of HDFN in Kenya. The group discuss the five pillars of prevention, diagnosis, monitoring, treatment and maternal support and what they each look like for Kenyan families. An important and humbling episode for listeners who may not have access to a deeper understanding of HDFN realities in underserved communities. Watch this episode on YouTube [https://youtu.be/cvqjF44pKyQ] View all of our resources at www.allohopefoundation.org [http://www.allohopefoundation.org] If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancy [https://www.facebook.com/groups/antibodiesinpregnancy] Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD.  Click here  [https://allohopefoundation.org/get-involved/donate/] to make a one-time or recurring donation.

Baby is Home, What Now?

Molly and Bethany address the common question many families wonder about what to do to monitor their HDFN baby once they’re home, and how to know when baby is finally cleared of HDFN. They share their children’s post-discharge monitoring plans, which cover a full spectrum of HDFN severity. If you haven’t already, listen to Season 1 Episode 13 about the neonatal HDFN period. Common terms discussed in this episode:  * Newborn hemolytic anemia * Newborn hyperbilirubinemia  * Hemoglobin/hematocrit * Reticulocytes * Erythropoietin/darbepoetin/ESAs * Thrombocytopenia * Neutropenia * Pediatric hematologist Example transfusion thresholds provided in our Excellent Neonatal Care Practices resource here. [https://allohopefoundation.org/advocate/provider-checklist/] References in this episode:  Clinical study showing the effectiveness of ESAs for neonatal HDFN:  Ree IM, de Haas M, van Geloven N, Juul SE, de Winter D, Verweij EJ, Oepkes D, van der Bom JG, Lopriore E. Darbepoetin alfa to reduce transfusion episodes in infants with haemolytic disease of the fetus and newborn who are treated with intrauterine transfusions in the Netherlands: an open-label, single-centre, phase 2, randomised, controlled trial. The Lancet Haematology. 2023 Dec 1;10(12):e976-84. Watch this episode on YouTube [https://youtu.be/wvOoTaybcW0] View all of our resources at www.allohopefoundation.org [http://www.allohopefoundation.org] If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancy [https://www.facebook.com/groups/antibodiesinpregnancy] Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD.  Click here [https://allohopefoundation.org/get-involved/donate/]  to make a one-time or recurring donation.

Quick and Nerdy: Iron

Bethany and Molly address iron and its dangers to the HDFN newborn in this quick, science-based episode. Together they address the dangers of iron overload and the confusion around why iron is often mistakenly included in the treatment regimen for newborns experiencing alloimmunized anemia, as well as treatments for extreme conditions.  Watch this episode on YouTube [https://youtu.be/y7ZznU6Sw5M] View all of our resources at www.allohopefoundation.org [http://www.allohopefoundation.org] If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancy [https://www.facebook.com/groups/antibodiesinpregnancy] Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here [https://allohopefoundation.org/get-involved/donate/] to make a one-time or recurring donation. References in this episode:  Study on iron overload at birth in HDFN newborns: Rath ME, Smits-Wintjens VE, Oepkes D, Walther FJ, Lopriore E. Iron status in infants with alloimmune haemolytic disease in the first three months of life. Vox Sang. 2013 Nov;105(4):328-33. doi: 10.1111/vox.12061. Epub 2013 Jun 27. Available here. [https://scholarlypublications.universiteitleiden.nl/access/item%3A2881417/download#page=194] Case report of iron overload resolving: Adam DL, Bowes L, Goodyear L, Moorehead PC. Conservative Management of Hyperferritinemia in Hemolytic Disease of the Fetus and Newborn: A Case Report and Review of the Literature. J Pediatr Hematol Oncol. 2021 Mar 1;43(2):73-76.  Available here [https://www.academia.edu/download/112861145/mph.000000000000158620240329-1-xfsqjs.pdf] .

Navigating the NICU With Your HDFN Baby

Katie rejoins Bethany and Molly to discuss the NICU experience including why HDFN babies sometimes need NICU time, how long and how often NICU is necessary, what to expect to hear and see in the NICU, and important resources to prepare and navigate an HDFN NICU experience. Watch this episode on YouTube [https://youtu.be/y7ZznU6Sw5M] View all of our resources at www.allohopefoundation.org [http://www.allohopefoundation.org] If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancy [https://www.facebook.com/groups/antibodiesinpregnancy] Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here [https://allohopefoundation.org/get-involved/donate/]to make a one-time or recurring donation. References in this episode: Neonatal excellent care checklist: available here [https://allohopefoundation.org/advocate/provider-checklist/].  HDFN Health Record: available here [https://allohopefoundation.org/hdfn-health-record/].  Merch store to get a “I wear my sunglasses at night” onesie:  access here [https://allo-hope-foundation.myspreadshop.com/] .

Quick and Nerdy: Maternal IVIG

In this quick, science-focused episode, Molly and Bethany break down how IVIG (intravenous immunoglobulin) is used during alloimmunized pregnancies to help delay fetal anemia and reduce the risks of severe HDFN. They explain who may benefit, how the treatment works, what the latest guidelines say, and why IVIG can be a life-saving tool when started early and used thoughtfully. Watch this episode on YouTube [https://youtu.be/G7SLFBTscOM] View all of our resources at www.allohopefoundation.org [http://www.allohopefoundation.org] If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancy [https://www.facebook.com/groups/antibodiesinpregnancy] References in this episode:  New meta-analysis on use of IVIG: Mustafa HJ, Sambatur EV, Pagani G, D’Antonio F, Maisonneuve E, Maurice P, Zwiers C, Verweij JE, Flood A, Shamshirsaz AA, Jouannic JM. Intravenous immunoglobulin for the treatment of severe maternal alloimmunization: individual patient data meta-analysis. American journal of obstetrics and gynecology. 2024 Oct 1;231(4):417-29. Available here. [https://www.sciencedirect.com/science/article/abs/pii/S0002937824005088] Benefits of delaying first IUT to beyond 20 weeks: Lindenburg IT, van Kamp IL, van Zwet EW, Middeldorp JM, Klumper FJ, Oepkes D. Increased perinatal loss after intrauterine transfusion for alloimmune anaemia before 20 weeks of gestation. BJOG. 2013 Jun;120(7):847-52. Available here. [https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.12063] Pregnancy management guidelines: Moise KJ, Markham KB, Spinella PC, Sherwood MR, Robinson KA, Wilson LM, Malone J, Espinoza J, Dizon-Townson D, Mercer L, Miller R. A Clinical Practice Guideline for the Management of Pregnancy Alloimmunized to Red Blood Cell Antigens. JAMA Network Open. 2025 Nov 3;8(11):e2544649-. Available here. [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2841768] Note that additional practice points are in the supplemental content. To access all recommendations, practice points, and their rationale, we recommend clicking “supplemental content”, downloading the file, and accessing Table 4. This provides all information in one table for easy printing and reference. Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD.  Click here [https://allohopefoundation.org/get-involved/donate/]to make a one-time or recurring donation.