Help!

I've been consulted in my role as medical liaison for the local breastfeeding
resource center regarding a 6 wk old with prolonged jaundice.

Baby weighed 7-13 @ birth; now weighs 11-12. Exclusively breastfed, and
mother also "occasionally" tandem nurses her 2 year old.

Seen at the doc's office yesterday, and had a total bili of 9.6.  By the LC's
report, the direct fraction, CBC, and LFT's were all normal.  Mom was advised
to give a couple of bottles of formula per day until next week when bili
would be rechecked.  She does NOT want to do this if she doesn't have to, and
is looking for some medical literature to back her viewpoint.

On the quick, via MEDLINE & Dr. Lawrence's text, was able to find some
support for not intervening unless a pathologic cause could be found, or bili
was >16 mg/dL for greater than 24 hours.  However, not many articles
available at our local med library, and will have to send off for them.  I've
already talked to the doc, who seems amenable to watchful waiting, and
continued exclusive breastfeeding, but would like to be able to send him more
than a few pages of text.

Any ideas?  Thanks in advance, and feel free to respond either via the list
or privately by email.

Mary Schultz, MD
Peoria, IL
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