I just had to jump in on this conversation.

I have no research, just a personal anecdote. My first son (now 20yo)  "looked" jaundiced to me the first few weeks, but my family & friends kept saying it was just his Mediterranean (Italian-heritage father) roots. He was a VERY alert, vigorous nurser, lots of pees & poops the first 3-4 weeks, then spaced out to once or twice a week thereafter (drove my m-i-l nuts!).

When we went for his 1 month checkup, the ped (a childhood acquaintance of mine) said, "That baby is jaundiced--why didn't you call me?" After I picked my heart up off the floor, she sent us straight to the local children's hospital for a bili check. Direct was okay, indirect was 18+.

My ped looked at the whole picture: thriving, active, alert baby, normal direct bili, abnormally high indirect but still under 20. She diagnosed breastmilk jaundice, scheduled him for weekly bilis, gave me explicit instructions as to what to watch for, and sent us home 100% breastfeeding w/her blessings.

His bili remained elevated, slowly decreasing, for almost 4 months. Looking back at his baby pictures, he was orange as a pumpkin until at least 3 or 4 months. In fact, that's the only way we can tell his baby pictures from those of his little brother--who, BTW, never developed breastmilk jd (highest bili was 9 a week into his 2 weeks in NICU for sepsis).

Sooo.....I agree this mom needs a second opinion, maybe even a third, but she also needs reassurance about the positive signs as well: good weight gain, alert baby, NORMAL decrease in stooling.

As to long-term damage from prolonged elevated bili (UNDER 20, that is!)--this child is a 20-year-old college senior, fluent in Spanish & halting in Chinese, perfect score on the SAT (college entrance exam, for non-US readers), bright, inquisitive, and all-around good kid. The only "damage" might be in his seeming inability to turn in homework on time! Has cost him several points on his grades, but otherwise, no ill effects. ;-)

Please keep us posted on this baby's progress.

Smiles,

Carol

Carol Schlef, RNC, MSW, IBCLC, LCCE

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