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Babies with jaundice


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  #1  
May 9th, 2007, 01:08 PM
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There is a lot of mixed information about what is best for a baby with newborn jaundice. Some say formula, others say breastfeeding. What are your opinions?

I breastfed my jaundiced baby with no ill effects.
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  #2  
May 9th, 2007, 01:12 PM
Ms.Michelle
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I have to ask this.. I've been researching all sorts of "normal procedures" doctors have. Is this just another one they have a recommendation on and we mainly just follow because we assume it's the best advice? (After all it's a doctor.)
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  #3  
May 9th, 2007, 01:15 PM
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I have to ask this.. I've been researching all sorts of "normal procedures" doctors have. Is this just another one they have a recommendation on and we mainly just follow because we assume it's the best advice? (After all it's a doctor.)[/b]
Yep, pretty much.

Doctors can't seem to agree on this, some will tell you to supplement and others will tell you to bf.
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  #4  
May 9th, 2007, 01:19 PM
jodi16ss's Avatar Mega Super Mommy
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Why is it that they recommend formula for a BF baby? It seems to me that breastmilk would be best. Is there something in BM that worsens the jaundice?
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  #5  
May 9th, 2007, 01:34 PM
Caeden'sMama's Avatar Mega Super Mommy
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Quote:
I have to ask this.. I've been researching all sorts of "normal procedures" doctors have. Is this just another one they have a recommendation on and we mainly just follow because we assume it's the best advice? (After all it's a doctor.)[/b]
Yep, sadly... Again, not all doctors are very educated on this. Also, i think sometimes it's easier for them to just say "give formula" than to take the actual time to help educate the mother, and work with her on her breastfeeding relationship...

Quote:
Why is it that they recommend formula for a BF baby? It seems to me that breastmilk would be best. Is there something in BM that worsens the jaundice?[/b]
No. There IS "breastmilk jaundice" which is normal, and not harmful... But for "normal" jaundice, everything i've read says continuing to nurse as often as possible is the best course of action. Formula does nothing.
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  #6  
May 9th, 2007, 01:40 PM
Pure Innocence
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Quote:
I have to ask this.. I've been researching all sorts of "normal procedures" doctors have. Is this just another one they have a recommendation on and we mainly just follow because we assume it's the best advice? (After all it's a doctor.)[/b]
yes YES YES!!!! It's all just a scam!! LOL! No seriously, jaundice CAN be serious, but 75% of babies it seems like gets jaundice. It's totally normal for babies to be a little jaundice and BM is better, not powder.
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  #7  
May 9th, 2007, 02:17 PM
donomama
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Oh, I just saw this thread.

This is a sore subject for me. It seems that peole assume that since I gave my son formula, they think I did no research. My son was at a level 23 and his levels were going up, not down. With both of my babies, my milk has taken a little long to come in. The way bilirubin gets out of the body is that it gets flushed out with fluids. Well, when mama doesn't have anything but colostrum, there really isn't much to flush out the bilirubin with. I was told that at level 25, they talk about a complete blood transfusion. I know that at some level (20-22) brain and neurological damage may be possible. I felt that we needed to flush out the bilirubin asap. My son was hospitalized and put under the phototherapy. I could take him out of the lights once every 2-3 hours. Everytime I took him out, I bf on each side for 10-15 minutes and then gave him as much formula as he would take. They told me I could supplement with water if I wanted to, but since the formula is thicker than both BM and water, that the bilirubin binds better to it and it gets flushed out quicker. While he was under the lights, I pretty much pumped nonstop because I didn't want it to effect my milk supply. You should have seen my boobs - doing a dry pump before your milk comes in for hours a day doesn't do pretty things!


Anywho.... I feel that, for us, supplementing was the best choice and it didn't effect my supply in the slightest, I believe mostly because I made sure it didn't. I hate it when someone hears jaundice, assumes it is breastmilk jaundice, or that you're a dummy for giving formula.
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  #8  
May 9th, 2007, 03:14 PM
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formula is thicker than both BM and water, that the bilirubin binds better to it and it gets flushed out quicker.[/b]
I have no idea whether or not that is true, but I was told the opposite. I was told that breastmilk passes through the digestive system more quickly than formula so it would "flush out" the jaundice faster.

The doctors really need to get together and figure out what the actual answer is, not tell one person one thing and someone else another.
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  #9  
May 9th, 2007, 03:25 PM
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Quote:
Quote:
formula is thicker than both BM and water, that the bilirubin binds better to it and it gets flushed out quicker.[/b]
I have no idea whether or not that is true, but I was told the opposite. I was told that breastmilk passes through the digestive system more quickly than formula so it would "flush out" the jaundice faster.

The doctors really need to get together and figure out what the actual answer is, not tell one person one thing and someone else another.
[/b]
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  #10  
May 9th, 2007, 03:30 PM
donomama
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Here is an interesting article from the Journal of Pediatric and Adolescent Medicine. It is from a study where they found that infants who received formula, in addition to their breastmilk, responded much better to phototherapy than exclusively breastfed babies:Link

From their conclusion:

Quote:
The addition of formula to the feedings for totally breast-fed infants, without suspension of breast-feeding, would enhance the efficacy of phototherapy and reduce exposure time.[/b]
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  #11  
May 9th, 2007, 03:37 PM
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It is a load of WHOOEY!! With DD, this is what ruined our BFing relationship. Macey's bilirubin was up to 27, and she was hospitalized and put under the lights. She was too weak to nurse and I was pumping and giving her the milk with a syringe. The nurses and doctors were telling me to give her formula that it would help her to get rid of the bilirubin. After several refusals, I was basically threatened, that if I didn't give her formula they would take her and they would. I gave in. It destroyed our BFing relationship, it destroyed my supply. I tried to BF for almost 2 months and I just couldn't recover my supply because I was having to supplement the whole time.

After DS was born, he too had jaundice. His bilirubin went up to 29, I refused to give the bottle despite the constant advice about how much it would help from the nurses. The ped that was on call at the hospital was not my own and he told me that if Sam's bili did not start dropping that he would make me give him the formula. I called my ped, who was very supportive of BFing, and she said that as long as Sam was wetting and dirtying diapers that there was nothing for me to worry about. I did wake Sam up every 30-45 mins to BF him. He was hospitalized for 4 days when his bili levels had dropped enough to release us back home.
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  #12  
May 9th, 2007, 03:49 PM
donomama
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Stacey - what did you do to keep up your supply while you were supplementing? I'm not arguing that supplementing can't ruin a bf relationship, but from what I have read, study after study has proven that babies supplemented with formula respond better to phototherapy and their bilirubin levels come down MUCH quicker.

I'm the first to back up breastfeeding, and I'm definitely not saying that every mother should supplement, but I do think it is the quickest way to lower the count. And with the right precautions, it shouldn't affect the bf relationship at all.
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  #13  
May 9th, 2007, 04:14 PM
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Quote:
It is a load of WHOOEY!! With DD, this is what ruined our BFing relationship. Macey's bilirubin was up to 27, and she was hospitalized and put under the lights. She was too weak to nurse and I was pumping and giving her the milk with a syringe. The nurses and doctors were telling me to give her formula that it would help her to get rid of the bilirubin. After several refusals, I was basically threatened, that if I didn't give her formula they would take her and they would. I gave in. It destroyed our BFing relationship, it destroyed my supply. I tried to BF for almost 2 months and I just couldn't recover my supply because I was having to supplement the whole time.

After DS was born, he too had jaundice. His bilirubin went up to 29, I refused to give the bottle despite the constant advice about how much it would help from the nurses. The ped that was on call at the hospital was not my own and he told me that if Sam's bili did not start dropping that he would make me give him the formula. I called my ped, who was very supportive of BFing, and she said that as long as Sam was wetting and dirtying diapers that there was nothing for me to worry about. I did wake Sam up every 30-45 mins to BF him. He was hospitalized for 4 days when his bili levels had dropped enough to release us back home.[/b]
I think it's awesome that you stood up to the doctors. Has anyone ever told you that you ##### rock?
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  #14  
May 9th, 2007, 04:19 PM
Cereal Killer's Avatar I'm climbin' in yo window
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Quote:
Stacey - what did you do to keep up your supply while you were supplementing? I'm not arguing that supplementing can't ruin a bf relationship, but from what I have read, study after study has proven that babies supplemented with formula respond better to phototherapy and their bilirubin levels come down MUCH quicker.

I'm the first to back up breastfeeding, and I'm definitely not saying that every mother should supplement, but I do think it is the quickest way to lower the count. And with the right precautions, it shouldn't affect the bf relationship at all.[/b]
I pumped and went back to BF a few days later, I just never could get back to EBF, after the interruption I always had to supplement. She was 2 days old when DD was admitted for jaundice and I was forced to bottle feed her. Those three days in the hospital they would NOT LET me BF her or give her the pumped milk. They FORCED me to give her only formula.
With DS, his bilirubin was higher than DD and I only BF, never gave formula and his higher bili level came down just in the same amount of time as DD's.

Quote:
Quote:
It is a load of WHOOEY!! With DD, this is what ruined our BFing relationship. Macey's bilirubin was up to 27, and she was hospitalized and put under the lights. She was too weak to nurse and I was pumping and giving her the milk with a syringe. The nurses and doctors were telling me to give her formula that it would help her to get rid of the bilirubin. After several refusals, I was basically threatened, that if I didn't give her formula they would take her and they would. I gave in. It destroyed our BFing relationship, it destroyed my supply. I tried to BF for almost 2 months and I just couldn't recover my supply because I was having to supplement the whole time.

After DS was born, he too had jaundice. His bilirubin went up to 29, I refused to give the bottle despite the constant advice about how much it would help from the nurses. The ped that was on call at the hospital was not my own and he told me that if Sam's bili did not start dropping that he would make me give him the formula. I called my ped, who was very supportive of BFing, and she said that as long as Sam was wetting and dirtying diapers that there was nothing for me to worry about. I did wake Sam up every 30-45 mins to BF him. He was hospitalized for 4 days when his bili levels had dropped enough to release us back home.[/b]
I think it's awesome that you stood up to the doctors. Has anyone ever told you that you ##### rock?
[/b]
Yeah, it's been mentioned a time or two!

Quote:
Breastmilk jaundice peaks at 10-21 days, but may last for 2-3 months. Breastmilk jaundice is normal. Rarely, if ever, does breastfeeding need to be discontinued even for a short time. There is not one bit of evidence that this jaundice causes any problem at all for the baby. Breastfeeding should not be discontinued "in order to make a diagnosis". If the baby is truly doing well on breast only, there is no reason, none, to stop breastfeeding or supplement with a lactation aid, for that matter. The notion that there is something wrong with the baby being jaundiced comes from the assumption that the formula feeding baby is the standard by which we should determine how the breastfed baby should be. This manner of thinking, almost universal amongst health professionals, truly turns logic upside down. Thus, the formula feeding baby is rarely jaundiced after the first week of life, and when he is, there is usually something wrong. Therefore, the baby with breastmilk jaundice is a concern and "something must be done". However, in our experience, most exclusively breastfed babies who are perfectly healthy and gaining weight well are still jaundiced at 5-6 weeks of life and even later. The question, in fact, should be whether it is normal not to be jaundiced and is this absence of jaundice something we should worry about? Do not stop breastfeeding for “breastmilk” jaundice.

Not-enough-breastmilk Jaundice
Higher than usual levels of bilirubin or longer than usual jaundice may occur because the baby is not getting enough milk. This may be due to the fact that the mother's milk takes a longer than average time to "come in", or because hospital routines limit breastfeeding or because, most likely, the baby is poorly latched on and thus not getting the milk which is available (topic #5 Is my baby getting enough milk?). When the baby is getting little milk, bowel movements tend to be scanty and infrequent so that the bilirubin that was in the baby's gut gets reabsorbed into the blood instead of leaving the body with the bowel movements. Obviously, the best way to avoid "not-enough-breastmilk jaundice" is to get breastfeeding started properly (topic #2 Breastfeeding—Starting Out Right). Definitely, however, the answer to not-enough-breastmilk jaundice, is not to take the baby off the breast or to give bottles. If the baby is nursing well, more frequent feedings may be enough to bring the bilirubin down more quickly, though, in fact, nothing needs be done. If the baby is nursing poorly, helping the baby latch on better may allow him to nurse more effectively and thus receive more milk. Compressing the breast to get more milk into the baby may help (topic #17 Breast Compression). If latching and breast compression alone do not work, a lactation aid would be appropriate to supplement feedings (topic #6 Using a Lactation Aid).

Phototherapy (Bilirubin Lights)
Phototherapy increases the fluid requirements of the baby. If the baby is nursing well, more frequent feeding can usually make up this increased requirement. However, if it is felt that the baby needs more fluids, use a lactation aid to supplement, preferably expressed breastmilk, expressed milk with sugar water or sugar water alone rather than formula.[/b]
http://pediatrics.about.com/library/breast...stfeedingh.htm#
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  #15  
May 9th, 2007, 04:59 PM
donomama
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I pumped and went back to BF a few days later, I just never could get back to EBF, after the interruption I always had to supplement. She was 2 days old when DD was admitted for jaundice and I was forced to bottle feed her. Those three days in the hospital they would NOT LET me BF her or give her the pumped milk. They FORCED me to give her only formula.
With DS, his bilirubin was higher than DD and I only BF, never gave formula and his higher bili level came down just in the same amount of time as DD's.[/b]

Well that's just wrong that they wouldn't let you bf at all...


Can you show me a peer reviewed medical journal study that shows that exclusively breastmilk fed babies have their bilirubin levels lowered as quickly as those that are supplemented with formula? The study I provided had 3 groups, one of exclusively bf, one with exclusively ff, and one group that was both. The babies that were supplemented were significantly more responsive to phototherapy. I love about.com as much as the next person, but if I'm going to change my mind about supplementing being a good thing, I'm going need to see more than that. I'd like to see a study of several babies, not just one doctor's take on it.

All babies aren't the same, and I'm sure genetics and what not play a factor, but with me supplementing with formula and bf as much as I could, Donovan went from 23 to the "safe" level (I think it was less than 10) in about one day. You should have seen how much that kid was pooping and peeing! And we all know how nice and lovelyl those bili poops are!
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  #16  
May 9th, 2007, 07:57 PM
Cereal Killer's Avatar I'm climbin' in yo window
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Quote:
Quote:

I pumped and went back to BF a few days later, I just never could get back to EBF, after the interruption I always had to supplement. She was 2 days old when DD was admitted for jaundice and I was forced to bottle feed her. Those three days in the hospital they would NOT LET me BF her or give her the pumped milk. They FORCED me to give her only formula.
With DS, his bilirubin was higher than DD and I only BF, never gave formula and his higher bili level came down just in the same amount of time as DD's.[/b]

Well that's just wrong that they wouldn't let you bf at all...


Can you show me a peer reviewed medical journal study that shows that exclusively breastmilk fed babies have their bilirubin levels lowered as quickly as those that are supplemented with formula? The study I provided had 3 groups, one of exclusively bf, one with exclusively ff, and one group that was both. The babies that were supplemented were significantly more responsive to phototherapy. I love about.com as much as the next person, but if I'm going to change my mind about supplementing being a good thing, I'm going need to see more than that. I'd like to see a study of several babies, not just one doctor's take on it.

All babies aren't the same, and I'm sure genetics and what not play a factor, but with me supplementing with formula and bf as much as I could, Donovan went from 23 to the "safe" level (I think it was less than 10) in about one day. You should have seen how much that kid was pooping and peeing! And we all know how nice and lovelyl those bili poops are!
[/b]
I doubt these studies take into account the BM jaundice though. Macey was jaundiced due, mostly, to all the trauma from my attempt at a vaginal birth (forceps, vaccuum and finally c/s). Sam, on the other hand, was 6 weeks premature, VBAC (no forceps or other aids) and EBF. His jaundice didn't completely disappear for about a month or more. My ped told me that as long as he was eating, wetting and dirtying diapers and gaining weight, then he would be fine. Sam was released when his bili level fell below 17, Macey was released when hers fell below 17 as well. I was told, with Macey, to continue supplementing, I tried, instead to EBF and failed because those few days had devastated my supply and then my entire BFing relationship. With Sam, I only EBF and he was perfectly fine and healthy and gained weight as he should.
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  #17  
May 10th, 2007, 07:47 AM
Ms.Michelle
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Stacey and Tiffany..

I love how you both have information and experience to give.. It's awesome to see such an intelligent debate. Thank you!
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  #18  
July 23rd, 2008, 04:08 PM
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My DD was not as severly jaundiced but she was jaundiced and I exclusivly BF. They sent her home Jaundiced and said to expose her to natural sunlight for 15 minutes a day and that would help. If it wasn't better in a week come back in.
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  #19  
July 27th, 2008, 02:14 PM
beck12's Avatar Platinum Supermommy
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My DS was jaundiced as well. He had to be in the bili-light at the hospital & it delayed him being released by a day or so...but he was EBF & no one ever even suggested that I FF. I was told to take him home & set him in his diaper in front of the window as much as possible & see the Pedi in 3 days. I know EBF may slow the process but that doesn't bother me. I think if that is the case then that is how it was meant to be.
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  #20  
July 29th, 2008, 10:33 AM
TheOtherMichelle's Avatar Platinum Supermommy
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dd had jaundice, but I don't remember them telling me the levels. She also had some other health problems so the jaundice might have been put to the backburner. The last night we were in the hospital the nurses put her under the lights even though the doctor didn't think it was necessary. Personally I think they knew I was having a hard recovery and wanted to give me one more night of good sleep before going home. My milk took a long time to come in strong, I want to say 4-5 days, so I think that was the main reason for her jaundice. At the hospital I had no pressure to FF. Instead they gave me a manual pump and helped with latch and all that.
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