Fio
Some LCs might not worry this early, day 4, but I would. But I would not
panic yet. Let's see. If the jaundice was for a blood incompatibility then
that has nothing really to do with the bf and it should progress nicely.
However, knowing hospital routines as I do, it seems obvious that there was
mother baby separation in that the baby was in an incubator for 2 days. This
is usually done to facilitate nakedness and baby is not left in an open
crib. Or was the baby in any way preterm (probably not with birthwt of 7#12)
or otherwise sick? That would be a risk factor for poor feeding. Also the
bili lights do contribute to fluid loss and jaundice contributes to
lethargy. I think very likely some 'lack of bf' juandice got superimposed on
the incompatibility juandice due to the above factors. So yes they are
somewhat behind schedule on their progression of bf. If mom's milk is now
in, then baby should 'babymoon' with mom or kangaroo care constantly to feed
very very often and never having to cry or suck her hands or paci. this is
very very important and usually in 24 hrs there is a big improvement in the
bf progression and the wet/dirty diapers. However if mom has never had a
chance to really practice bf, and if mom has not had good help with
position/latch, and has the bf ever been looked at,, then maybe someone
should do this. If baby is not softening the breasts 10, 12 or more times
per day and increasing the diapers very quickly then mom should express and
feed to baby any time the feeding is not super good. She may need help
assessing what is good feed or not. Hope this was of some help. Follow her
closely at least every day. I think the baby should also get weighed again.
Very interesting cases here lately.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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