Jenny Thomas said:
The curves simply show who is at risk for having their current level of
bilirubin get higher.

Thank you for clarifying this for us, Jenny.  I was recently introduced to
Bhutani's work in this area and I find it to be a valuable tool in helping
to illustrate visually where a given baby might be and it does give a good
gauge of whether to intervene aggressively or watch and wait, where
previously nurses and doctors were just likely to see an "elevated"
bilirubin out of context and immediately jump to phototherapy or
interruption of breastfeeding.  The Bhutani curve, with consideration of
other factors, of course (whether the baby had a sibling who received
phototherapy, blood types of mom and baby, Coombs antibody status, ethicity,
hemolysis, etc.) gives those practitioners who like something concrete a
guideline for whether and how to intervene.  I think in the case of
preserving breastfeeding, it can be very helpful -- a doctor who sees a baby
that is less likely to see a higher bilirubin in hours or days might think
twice before calling in a preventive intervention, while those babies who
really are at danger (rare though they might be) of a bilirubin increase can
be addressed as well.

This is a topic of special interest to me because of personal history (and
perhaps future, my next baby is due in a few months), so I really appreciate
any insights you all have to share!  Thanks again.

--Diana in NY

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