Dear Chris
Thank you for your reply,  sorry I should have explained I am a team midwife
and recently the unit in which I work started prescribing babies (that were
DCT positive) Folic acid.  None of my colleagues were familiar with this,
nor could we find any information, references pertaining to the prescribing
of Folic acid to newborns.  The dose seemed high 500mcg per kilo birthweight
per day for 3 months.  It was to be used as a blanket prescription in that
all babies DCT pos should be given it, not just the babies that were
jaundiced or had high SBRs.
As I had failed to find any info Medline, Paedmed, PubMed etc I was
interested in finding out where else this is done.
Having read the article in Sept BJM 'Folic acid supplementation: Is it a
safe option?' (Mason & McNabb) re the concerns surrounding 'routine
supplementation' of Folic acid pre-conceptually and ante-natally, I am even
more concerned about giving it to babies.  Are we entering another "it's
just Vitamin K" situation.

thanks again for your reply
Gwenan

----- Original Message -----
From: Christine Booth <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, November 23, 2000 4:50 PM
Subject: Re: folic acid


>
> ----- Original Message -----
> From: Gwenan Thomas <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, November 20, 2000 4:44 PM
> Subject: folic acid
>
>
> Is anybody familiar with the practice of prescribing Folic acid to newborn
> babies who are direct coombs positive.  I am interested infinding out if
> there are any units that do this, and if anybody has any relevany
> information, refs etc
>
> many thanks  Gwenan
>
>
> Dear Gwenan,
>     Yes, the Paeds at out unit DO prescribe folic acid to babies whose
> Direct Coombs test is positive.
>      For the non-midwives on this list, the Coombs test detects maternal
> antibodies on the baby's red blood cells. These antibodies cause a
breakdown
> of the red cells (haemolysis). If cells ARE destroyed, to make new red
cells
> the baby needs Iron (a term baby will have stores, a pre term is given
iron
> as Sytron medicine), vitamin B12 (baby should have stores), and folic
acid.
>     In the unit where I trained, if the mum was RhDneg, after the birth we
> took the Kleihaur from Mum to detect if any fetal blood has got into the
> mum's circulation at the birth, which will cause antibody formation if the
> baby's blood is RhesusD pos. Then we took cord (baby's) blood to check the
> baby's blood group to see if it was the same as mum's.  We did the Direct
> Coombs AND a serum bilirubin to see if there HAD been any breakdown of red
> cells at that time. Incompatibility could also occur between mum/baby of
> different blood group (ABO incompatibility), never mind the Rhesus bit,
but
> that is a different story
>     It seems that any baby with a positive Coombs test goes on folic acid,
> at our unit, even with no symptoms eg jaundice, and even without doing a
> serum bilirubin test.
>     Hope this answer makes some sense, and is not too late.  It seems ages
> since I first saw your request for info, then your second notice saying
you
> had not had any replies.  I was just plucking up courage to make a
comment,
> as physiology is not my strongest point.  I did not know if you were a
> midwife just wanting a Yes/No answer, or if you wanted some explanation.
>                                         Love Chris Booth
>



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