I'm totally agreeing with Laurie about baby-cued feeds. ABO
incompatabilities are difficult because no one seems to really understand
them (often including the nurses) so read up so you seem like the expert you
are.

Be sure you are using reflective surfaces (we use a while drawsheet) around
the baby so you're getting the most bang for your buck out of phototherapy.
And help the nurses remember that a good breastfeeding is such a great way
to trigger more stool, which will help the body get rid of the excess
bilirubin. The orders should read "at least every three hours" for feeds,
not every three hours! And remind nurses to help mom and baby get down to
business when the baby is cuing. There's no reason to do vital signs while
the baby is frantically cuing!

I've gleaned some great stuff from Madge Buss-Frank, a PNP in southern NH
who works with lots of NTIs (Near-Term Infants), who are more likely than
term babies to be jaundiced. However - my refs are at work and I"m at home
today.

Dawn Kersula MA, RN, IBCLC
in Vermont USA

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