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Subject:
From:
Pat Bull <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 15 Feb 1998 14:22:32 -0500
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>Baby less that 24 hours with a bili of 17 and + coombs.  Peds ordered
 double bank lites plus bili blanket, 30 cc of formula q 3 hours,
and baby not to be removed from under lights for any reason.  <

Stephanie,

Working many years in my private home phototherapy practice, whenever I
would get a case like this,  I would suggest to the Dr. the use of an SNS
(supplemental nutrition system).  With a positive coombs, most likely, the
increased bili will conti. for several days.  By wrapping the baby in the
biliblanket and BF with the SNS will at least get baby breastfeeding,
decrease chances of nipple confusion and stimulate mother to get her milk
in.  Not to mention baby getting the colostrum which I have always found to
be productive in getting the bili-ladened stools out.   The Dr. is happy
because he KNOWS that the baby is getting the calories, so a win-win
situation.  The baby in the blanket, out of the double banks for only the 
feeding times is still getting adequate irradiance of light.  I would
occasionally have
 the mother pump and put the milk in the SNS and feed that after her milk
"came in".
Good-luck.   (Sorry, I guess my posts are just going to be always messed
up)
"What most of us want is to be heard, to communicate" by Dory Previn

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL

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