Hello, All:  Our hospital is being visited the end of October by JCAHO
(national hospital accreditation body here in USA) and of course we have
all been industriously reviewing policies & procedures, etc. in
preparation.  Our department director brought to my attention A "Sentinel
Event Alert" published by JCAHO in April, 2001 re: guidelines in the
management of hyperbilirubinemia.  Apparently there is concern in the
medical community that kernicterus is on the rise.  Some of the JCAHO
recommendations are #1(!) Promote and support successful breastfeeding.
Also recommended is that "women who are breastfeeding receive appropriate
oral and written instructions about newborn jaundice.  Infants should be
breastfed at least eight to 12 times a day for the first few days to
stimulate milk production and help keep the baby's bilirubin level down."
The AAP (American Academy of Pediatrics) is also recommending "...and
support and promote breastfeeding with on-site certified lactation
counseling in support of breastfeeding."  Does this mean there is hope
after all?
This information can be found at www.jcaho.org as well as at www.aap.org.
The AAP's recommendations are a lengthy (but interesting)document.

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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