Recently at work, a new OB resident saw a two -day old, slightly jaundiced
baby and said " oh, I think this is breast milk jaundice, should the baby stop
breastfeeding to be on the safe side?"  I had not heard this term in years, but
it seems to be making a comeback.  After talking a long time with the doc, discovering what she "learned" in med school, I hit the books. Several books and 17 articles later. . .

In Lawrence's book, she differentiates between "breastmilk" jaundice,  and "breastfeeding" jaundice.

"Breastmilk" jaundice is that related to something actually in mom's milk,  occuring maybe in 1 of 200 breastfeeding moms; has a late onset, and needs breast feeding to be stopped *in order to make a differential diagnosis.*  But if you stop breastfeeding, don't put the kid under lights, or you won't know
which the decreasing bili is a response to.  Similarly, if the kid is under lights, and you keep breastfeeding, the bili should still go down.  So if you don't care about a *differential diagnosis,*  it seems to me there is no reason to stop breast feeding.  

"Breastfeeding" jaundice is an early jaundice, showing up in the first few days of life and peaking on about the fourth day, corresponding with "normal newborn jaundice."  It is related to the low volume of intake and low frequency of stools.  Lawrence points out that "BF jaundice" is a misnomer, in that it doesn't come from breastfeeding per se.  There is nothing is wrong with the food itself; and the process in the long run (when the milk comes in) rectifies itself.  Again not a reason to stop breastfeeding, but in fact, a reason to make sure that baby is put to breast often, to help insure a maximum intake and a maximum production of milk.            

It has been good to learn that heating mom's milk can ameliorate the cause of "breastmilk".

Now through lactnet, maybe we can bring about a change in the terminologies, especially for "breastfeeding" jaundice,  which would not lead us to infer that breastfeeding and breast milk are the culprits.  First Lactnet, then the world!!  (IMHO)

Chanita, in San  Francisco