There is NO reason to stop breastfeeding for jaundice.  None at all.  I don't
think I'd even bother to treat this baby's bili with phototherapy.  The bili
isn't rising fast from the initial one at 22 hours (8.3) and the one at 38
hours (11.0).  NORMAL high bili for a breastfed infant at about 3-4 days is
up to about 15-16 (see AAP practice parameter on bili).  A bili of 11 is not
the least bit dangerous or worrisome.  The mom can refuse to allow formula
supplement, refuse phototherapy, ask for another opinion, or sign the baby
out AMA with plans to followup with the pediatrician of her choice by the
next day.  The doctor is WRONG on this one.  Ask the doctor for the evidence
supporting his mismanagment.  The proof of management is on him.

Linda Shaw MD FAAP

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