Diane
hi i am up too late due to coffee and tomorrow is jcaho assessment. oh well
diane you ask about bili levels. my lab chart says total bili 2-6 mg/dl (<24
hrs); 6-7 (48 hrs); 4-12 (3-5 days) and it doesn't go further than that.
anyway 13 at day 10 is high. why is it high? is the baby feeding poorly? it
would seem so based on your descriptors: "has 'fair' poopie diapers, sleeps
5 hours at night, the client has raw nipples and has started to use a nipple
shield at night to protect her nipples a little from sloppy latch; The baby
nurses for 10 minutes at a time." Diane, if the baby were thriving i
wouldn't mind a 5 hr sleep, nor a 10 min feed, however the feeding sounds
problematic. what is the weight? i'd really want to know this? what is fair
poopie? most thriving bf babies are pooping ALOT at this point. what is
moms' milk supply like and how was it at onset of copious production in
early days? also, are there any factors to contribute to bili production
like ABO incompatibility, bruising, i.e. some pathology? it sounds like this
dyad need some serious bf help asap.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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