You mentioned that this baby seemed to have a lot of fluid on board when he was first born. That is what helps babies to not become dehydrated while their mother's milk supply is gradually increasing.
I think that the jaundice that you are worried about is not ABO incompatibility. The mother needs to be type O for that to be an issue. I think that the jaundice maybe due to not enough breast milk. This is also reflected by being 9 oz below his birth weight at 22 days of age. I think he needs more milk. The half oz-1 1/2 oz feeding are small feedings for a baby of his size.
I would encourage you to help the family decide on some way for this baby to get additional milk. A SNS or some other type of tube system at the breast would be useful since the mother didn't sound interested in pumping. I have found fenugreek useful for some mothers in this situation if they are getting frequent enough emptying of the breasts. Sincerely, Rachel Wahl RN IBCLC
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