I asked another forum about jaundice (never did get around to hunting out
medline - glued to my terminal as usual) and this is the result. I
haven't yet asked for permission to post, so have edited out the
individual names (plagiarism at its worst ;) and have just kept the
qualifications!

I have only included one full post as it was the best "potted description"
of the whys and wherefores of breastfeeding instead of complementing
or ceasing to breastfeed when the neonate has jaundice.

Snips and fwds start here....

-------
Many drs. will promote ABM and D/C BF or complement it with ABM because the
calories and protein will "line the infants intestines" and decrease chances
of reabsorption and recycling of the bilirubin.  That is why water or GW ( a
big 6 cal./oz) can increase chances of increasing bilirubin levels.  What
they do not realize, if babies will nurse frequently the initial  milk is
very high in proteins and additionally does have the laxative effect getting
rid of the meconium ( highly ladened with bilirubin).  Breastmilk also has
lactalbumin beneficial when unconjugated fat-soluble bilirubin travels
through the vascular system and is looking to attach to albumin sites. I have
done home phototherapy for many years with successful results continuing
infant with BF.  One of the keys is to make sure mother maintains a good milk
supply and baby is nursing frequently.   Mother just needs alittle education
and support that it is not her breastmilk that is causing the jaundice.  (
but the lack of her breastmilk in the case of physiologic jaundice)

From one who is finally seeing less and less of home phototherapy being done,
many drs. waiting until 18mg-20mg to treat.  YAAAAA
 RN, IBCLC
-------
"In addition to LLL literature, which is thorough and
professional, I don't know of another whole series.
Kay Hoover has an info sheet on jaundice which was
the source of my quotes the other day.
It is from vol 1.1 of Breastfeeding Times, Philadelphia
Department of Public Health, Office of Maternal and
Child Health, 550 South Broad St, Phila PA 19146-1696.
Kay's Philadelphia Breastfeeding
Resource Handbook is also a wonderful source of
information and has the addresses of many organizations
that publish breastfeeding info, as well as commercial
publishers, sources of videos etc."

LLLL & IBCLC
---------

REFERENCES

"The AAP discourages the interruption of breastfeeding in
healthy term newborns and encourages continued and frequent
tfeeding (at least 8 to 10 times in 24 hours)... Supplementing
nursing with water or dextrose water does not lower the
bilirubin level in jaundiced , healthy, breastfeeding infants"
American Academy of Pediatrics, Subcommittee on Hyperbilirunemia
Practice parameter:  Management of hyperbilirunemia in the
healthy term newborn.
Pediatrics. 94(4) 558-565, Oct. 1994.

There is a lot of new info supporting continued breastfeeding.

American Academy of Pediatrics and American College of Obstetricians
and Gynecologists:  Guidelines for Perinatal Care (3rd Ed).
AAAP:  Elk Grove Village, Ill 204, 206-207, 1992

Martinez JC, Maisels MJ, Otheguy et al.
Hyperbilirunemia in the breastfed newborn:  a controlled
trial of four interventions.  Pediatrics 912) 470 - 473

[Not sure of this one's qual's from memory IBCLC or RN but could be
Em Professor knowing my memory!!!  - Narelle]

-------
"LLL has a good pamphlet on Jaundice and the BF Baby."
IBCLC

References used in the LLL leaflet
-------
Auerbach, K.G. and Gartner, L.M. Breastfeeding and human milk: their
association with jaundice in the neonate.  Clin Perinatol 1987; 14:89-107.

Lascari, A.D. "Early" breastfeeding jaundice: clinical significance. J
Pediatr 1986; 108:156-158.

Murphy, J.F., Hughes, I., and Verrier-Jones, E.R. et al. Pregnanediol and
breast milk jaundice. Arch Dis Child 1981: 56:474-76.

Nicoll, A., Ginsberg, R., and Tripp, J.H. Supplementary feeding and jaundice
in newborns. Acta Paediatr Scand 1982; 71:759-61.

Lawrence, R.A., Breastfeeding: A Guide for ther Medical Profession.  St.
Louis:C.V. Mosby Co., 1985.
-----

"     Gartner, L.M.  Neonatal Jaundice.  Pediatrics in Review 15:422-432,
1994

     Gartner, L.M.  On the Question of Breastfeeding Frequency in the First
Five Days of Life and Neonatal Jaundice (of some title like that).  Seminars
in Perinatology, December 1994.  (See the whole issue - all on breastfeeding
in the hospital setting)        "
M.D.
Professor of Pediatrics and Obstetrics/Gynecology


LEAFLETS

"There is an excellent handout on jaundice which is available from
Ameda/Egnell.  It is (or was) referenced (at the time I wrote it) and the
last time I heard it was still available at a reasonable cost.
by
Mary Kay Smith, CLE, IBCLC, LLLL
c/o IRA 777"

"La Leche League has all of the
pamphlets you mentioned and many many more.  They are well referenced, and
very inexpensive.  You can get catalogues showing these and many other
resources by joining as a member for $30. per year, or call 1-708-519-7730
and ask for one.  To join as a member contact a local Leader, or send payment
directly to headquarters at :  P.O. Box 4079  Schaumburg, Illinois 60168-4079"
 LLLL & IBCLC


Known Researchers

Dr. Jeffrey Maisells from Detroit has done lots of work on BF and jaundice.

Narelle
_______________________________________________________________________
Narelle Clark
   o        o     Underfed, underwashed, underslept - but well loved.
  \ / o  o \ /          It's great being a parent!
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