It was believed by many that a baby with jaundice should not breastfeed,
because their bili levels generally take longer to fall than formula fed
infants do. Now most of us know that this isn't a problem, and that
interfering with breastfeeding is harmful. I have not seen a baby whose
hospitalization was prolonged by breastfeeding while jaundiced.

However... phototherapy does increase fluid requirements, especially in
low birth weight infants, as it increases water loss. And we sometimes
see breastfed babies return to the hospital after being home, jaundiced
and dehydrated. Our challenge is to preserve breastfeeding while
treating the hyperbilirubinemia and keep the baby hydrated. I deally,
you would put the baby to breast very frequently, keeping mother and
baby together all the time. This reduces the amount of time the baby
spends under the lights, though, and especially if the bili level is
very high, phototherapy is critical. It can keep a baby from needing an
exchange transfusion. Bili-pads and bili-blankets are helpful additions
to the treatment, but don't by themselves provide enough phototherapy to
reduce high levels of bilirubin. Additionally, babies who are very
jaundiced are often also very sleepy and don't nurse well.

If hydration is an issue, we generally accomplish this with IV fluids.
While IVs do not reduce bili levels, they do keep a baby hydrated.
However, IV fluid is not a completely benign therapy, as a neonatologist
I know likes to say. Supplementing with formula also carries risks.
Sometimes these things are necessary though, because allowing a baby to
remain dehydrated and jaundiced is also harmful. (I am not defending the
practice of giving water orally, which we don't do and which I find
alarming.)

Just my two cents worth.

Anne Stringer, RN, NICU
Michigan, USA

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html