Baby's platelet count drops to serious level

My eight-month-old baby recently contracted cough and flu from his nearly two-year-old sister. He developed all the usual symptoms like runny nose and coughing fits. In addition, I also noticed abnormal red spots on his left wrist and near his right eyebrow. He was not scratching them, and was not really bothered when I rubbed on these spots.

A day later, I noticed another peculiar thing: His stools were a blob of slightly transparent light pink jelly with streaky red stains. I could not figure out why his stools should look like that as we had not fed him any unusual foods recently. He had only had his usual chicken slices-potato-carrot porridge.

Initially, I brushed aside the thought of a serious illness as he was otherwise a happy baby. No fever, still had a big appetite and playful as ever! However, by the evening, bruises started appearing on his forehead, both his feet and shins; the common sites where a baby could get hurt while crawling and pulling himself up but he had never had bruises like that before. I decided to take him for a checkup at the nearest hospital after dinner that Sunday evening.

Since my husband was working the overnight shift that day, I brought along my helper and my daughter to the hospital. The doctor suspected that my baby’s platelet count was low and ordered a blood test.

Within about 15 minutes, the result was known. My baby’s platelet count was only 8,000 per microlitre. The normal platelet count ranges between 150,000 and 450,000 per microlitre! Platelets are blood cells which are important for blood clotting in our bodies. Normally, spontaneous bleeding can happen internally when the count drops below 50,000 and the red spots were signs of tiny bleeding activity going on under the skin spontaneously. The doctor advised that we should be admitted to the ward for a few days for monitoring.

Feeling at a loss, I called my husband but there was no answer, so I left him a message about us staying the night at the hospital, giving as much detail as I could so that he would not panic when he received it. I then called my boss to inform that I would be taking emergency leave the next day. Next, I called my parents-in-law, who happened to be in town. They came and took my daughter and helper home.

We were placed in the critical room as the staff needed to monitor my baby for any acute bleeding during the night. Five other sick babies were there with their mothers. Throughout the night I could hear them crying in distress, coughing and wheezing. They were all dependent on oxygen. When I breastfed my baby that night, tears welled up in my eyes as I never realised that he was so sick and I prayed desperately that it was not too late and he would not have internal bleeding in the brain or anything serious like that, but would have an uneventful recovery.

The medical officer briefed me that my baby most likely had a condition called idiopathic thrombocytopenic purpura (ITP). The cause is usually unknown, but in this case it could be triggered by the viral infection resulting in his own antibodies mistakenly targeting and destroying his own platelets (autoantibodies) for the virus.

He said that the best thing to do for the moment was to monitor the platelet count daily and that we did not need to rush into any invasive treatment(s) yet until and unless he showed any signs of active bleeding. That night, my baby was pricked another time to look for other more serious causes. My husband came to the hospital for a short while as his employer saw that he was too distraught to work properly. He came, got us our essential things, and after realising that our baby looked as well as ever and that the doctors had a reasonable plan of management, he went back to work.

The next morning at 5.50am, my baby was taken away for another blood test. The platelet count had gone up to 13,000. In the afternoon, the specialist ordered a second blood test for the day. The result came back as only 15,000. I secretly prayed to God that the platelet count would not only be on an upward trend, but would double, triple and quadruple every day.

On the second morning, my mother-in-law came to relieve me so I could go back to work. When I left the hospital at 6am that day, my baby was going for another blood test. My poor baby was frantically crying and struggling whenever they held him still for the procedure. By now, we noticed that it was less traumatic when he was held still sitting up instead of left lying on the bed when the doctors pricked his arm or foot.

At 8am, I received a text message from my mother-in-law to tell me that the platelet count had gone up to 44,000 and he was moved to the non-critical room to make space for other sick babies.

When I finished work, I came back to relieve my mother-in-law for the night as the next day happened to be a public holiday. When I was with him, my baby was as active as ever. The doctors reminded me to make sure he did not knock his head against any surface as it would trigger massive internal bleeding.

The next day, his platelet count really tripled to 122,000! Praise God! We were allowed to be discharged as it seemed the worst had passed. His skin bruises also were clearing up with no new spots appearing, and his bowel movements were back to normal.

Grace Cheah