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Lactation Information and Discussion

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Subject:
From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 8 Apr 2009 08:04:05 -0400
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Babies resorb bilirubin from the stool in their guts when there is not
enough turnover of the gut contents to flush bilirubin out.  It is the case
that exclusively artificially fed babies on average have lower bilirubin
levels than their otherwise similar breastfed peers.  But a baby who is not
getting enough food will have higher bilirubin levels than a baby who is
feeding well, regardless of what they are fed.  Still, the strikingly low
bilirubin levels in artificially fed babies has led a number of people to
question whether bilirubin is all bad, or whether it has some biologically
adaptive function in newborn mammals.

Babies who don't feed well, are more likely to get jaundiced.  Babies who
are very jaundiced, may feed poorly because of the effects of the jaundice,
though in my experience it is hard to separate the possible effects of the
jaundice from the very real effects of the treatment, particularly when
babies are separated from mothers during phototherapy, and only allowed
brief breaks in order to feed.  In addition, many breastfed babies are still
being born in places that restrict the frequency and duration of feeds
either by design or de facto through birth practices that hinder normal
breastfeeding, so their total intake is far less than it might be if they
were free of medications and traumatic injuries and in continuous contact
with their mothers.

Anyone suggesting an intervention with known negative effects, like feeding
breastmilk substitutes to newborns, should be required to document the need
for such a measure, in every case, with a convincing argument justifying the
known risk for a potential benefit. Perhaps the new pediatricians have been
attending industry-sponsored so-called educational events, or have just been
visited by a formula sales rep with a lot of glossy brochures, and don't
really have solid evidence for their practice. It's at least a possibility,
and someone needs to ask, on behalf of babies.

Rachel Myr
Kristiansand, Norway

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