Dear Linda, I hope you've had a chance to calm down.  Had baby lost a lot
of weight by discharge? (dehydrated at discharge?)   Were baby and mom
separated a lot in the first few days (baby didn't get enough chance to
breastfeed).  Is there a blood incompatibility problem?  (more hemolysis?)


I don't think many would argue that the baby needs lights at 21.8.  You can
argue tho whether or not BF needs to  be totally D/C'd. In a 1993 article
Dr. Martinez, Maisels and others said that "If the infant is significantly
jaundiced and a decision is made to intervene, parents can be given a
number of options and can make an informed decision regarding which, if
any, intervention they prefer."  Pediatrics 1993;91:470-473.  They used 4
methods on babies >17 mg/dL. 1) continue BF and observe.  2) discontinue
BF, substitute formula.  3) discontinue BF, substitute formula, administer
phototherapy.  4) continue BF, administer phototherapy.  3 & 4 were better
than 1 & 2.  3 was best, but none of the results were strong.  But
certainly breastfeeding and single (or double) phototharapy is a valid
option.

The authors really stressed the fact that it is THE PARENTS CHOICE after
offering options,  to make a choice of treatment.  Now I grant you that is
a very odd notion  in the US, that parents can help pick and choose and
direct their baby's therapy, but there it is  in Pediatrics in black &
white by respected authors!
Sincerely, Pat in SNJ

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