Dear Elisheva,

Maybe I'm an alarmist, but I would be concerned about a baby who was that
yellow and hadn't been evaluated, especially when there may be a feeding
problem.  Without any testing having been done at all, how do you know
for sure that this is just a case of benign, late-onset jaundice and not
something more pathological, perhaps involving the liver?    Increased
alertness is a very good sign.  How about weight gain, stools, etc?  Of
course, if it is just late-onset jaundice, a high bili count might just
get everyone all upset for nothing.  Still, if it were my baby, I'd want
to know the total and direct bili.

I guess one of the reasons I am so worried is that the last time I saw a
baby that looked like a pumkin, she was about 2 weeks old and already had
kernicterus by the time she came into our emergency room.  My son had a
bili of almost 20, but still wasn't close to being that orange.  Of
course, there are going to be big individual differences in how high the
bili is compared to the actual bilirubin level.  Still, a bright orange
baby is hard to ignore.

Just my $.02 worth.

Sharon Knorr, BSMT, LLLL, IBCLC
Lactation Consultant Services
Rochester, New York
mailto:[log in to unmask]


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