Depends on how elevated and have all reasons for elevated bili been 
investigated!  Are we talking about Direct or indirect bilirubin?  And No, 
she should not stop breastfeeding and Yes, get a second opinion from a more 
knowledgeable person, like a Children's Hospital liver specialist.

There are many articles on hyperbilirubinemia and it's causes.  Late 
hyperbili, like this baby, need to be investigated for other sources like 
Hemolytic disease; Hypothyroidism; Pyloric Stenosis; Crigler Najjar 
Syndrome; Extravascular blood. (Maisels, 1988.)

Breast milk jaundice is usually seen 5-8 days of life and can be dx by 
stopping BF for 24-48 hrs (while protecting mom's milk supply) or 
alternating BF and formula feeds for 24-48 hours and observing a drop in 
bilirubin.  Full breastfeeding can then begin again with a small rise in 
bili.  Baby can remain visably jaudiced for up to 3 mo.

I'm sure there is more up-to-date info at www.llli.org,; www.kellymom.com
or www.breastfeedingonline.com or any of the BF textbooks.
It's late and I'm tired and I get mad at people who blithely blame 
everything on breastfeeding!

Pat in SNJ, APN, IBCLC 

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