A bili of 17 in a baby less than 24 hours is certainly high enough to merit
phototherapy; more importantly, it merits investigation into its etiology, as
these are usually babies with ABO incompatibility. The high bili has NOTHING
to do with breastfeeding at this age. The baby should be kept on
breastfeeding; with a bili-blanket, the baby can be held for breastfeeding
while the phototherapy continues, then replaced into the double-bank unit
after feeding. If the physician is concerned about calorie intake, some
supplement can be given with a nursing supplementer along with the
breastfeeding, but at 24 hours of age, lack of calorie intake is NOT the
etiology of this baby's high bili.
Linda L. Shaw MD FAAP