I need some help from all my fellow lactnetters out there.  This is my first
time posting so bare with me.  I have done a serch of the archives but
haven't quite found the information I am seeking.

I am an RN IBCLC in a small rural community in upstate NY.  On 9/2 my sister
gave birth to a baby boy 36.3 weeks and weight was 6lbls 2 oz.  He has
Down's Syndrome.  He has surprisingly good tone for a Down Syndrome baby, a
slight cardiac murmer was heard but has no signs of failure.  He won't see
the cardiologist until early OCT.  He also had a cepholohematoma from birth.
He latched and nurse beautifully within 1 hr of birth once but then didn't
latch again till that eve.  The baby was very tired from all the initally
testing that was done when the diagnosis of Downs syndrome was made. When he
wouldn't nurse he was supplemented with formula with a syringe. Pumping
began and ebm by bottle or syringe was given whenever he was too tired to
latch ( he would latch about every other feed)

On day three he was jaundice with a bili of 17.3 and phototherapy was begun.
He was just allowed formula for appox 18 hr and then ebm restarted. Bili
came down to 13 by late after noon and babe was discharged home. Mom was
nursing directly and pumping when needed to refeed.
On day 7 bili rose to 23, again readmitted for photo therapy for 48 hrs,
again Ped stopped breastmilk for appox 24 hrs then allowed mom to nurse
again.  Discharged on day 9 with bili of 14.1
Daily bili checks done and in the first 24 hr bili was 15.3  The following
day bili was 18.7  Mother was given a home phototherapy (walloby unit) again
told to stop breast milk feeds.  Today after 24 hrs of home therapy bili is
15  Ped told her she could breastfeed every other feeding and continue
phototherapy.

I know intake is adequate because at this point the  baby is getting all his
breastmilk via bottle and is taking 2 ounces every 2 hrs.  Many wet diapers
and stooling daily.  Stools now appear as a normal yellow breast fed stool.

As far as I know no other testing has been done yet to check for metobolic
disorder.  Mom is A + so hemolytic disease isn't a problem.

Are Down's syndrome kids more prone to jaundice and if so will this little
one ever be able to have his mothers milk?  My sister has nursed 3 other
children successfully with only the normal newborn jaundice that never
required further treatment.  She really wants to nurse this baby too but is
getting very scared that she is doing more harm then good

All suggestions would be greatly appreciated

Joan Mcallister RN IBCLC
Hornell NY

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