I'm not sure if you use the same #s as we do in US.  10.4 would be in the
realm of possible for true breastmilk jaundice at 4 weeks and it wouldn't
be bad, as long as indirect #  is low.  If indirect is a high part of this
10.4 then the HCP should be looking for a reason (serious stuff).  I don't
think a bilirubin of 10 affects a 4 week old.  Many of us have seen babies
with these sorts of numbers eating and thriving.  This baby is NOT
thriving.

I would be very concerned about the mother's actual milk supply at this
point and about effective milk transfer.  I would probably give her
fenugreek and have her dbl pump with a good hospital grade pump.  I would
really be looking at baby's suck/swallow.  Frankly this baby probably stops
eating because she isn't rewarded.  She is probably sucking poorly from
plain starvation.  Use a supply line or cup or dropper feed, but FEED this
baby.  1. Feed the baby.  2. Protect  (build) the milk supply.  3. Fix the
breastfeeding.
Sincerely, Pat in SNJ

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