Hyperbilirubinemia is an extremely complex area - one "safe" bilirubin level
does NOT fit all!  A safe level depends on the cause of the jaundice, the
gestational age and weight of the infant, the postnatal age of the infant,
and other co-morbidities (such as acidosis, sepsis, etc.).  As breastfeeding
has increased, there has been a resergeance of (preventable) kernicterus - so
much so that the JCHAO has issued warnings and guidelines for hospitals.  The
problem is NOT the breastfeeding, it is the lack of follow-up of
breastfeeding (and poorly breastfeeding) infants.  The latest review by Dr.
Gartner is in Pediatric Clinics of North America, April 2001.
Nancy

Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA

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