Almost 16yrs ago I took home a skinny little 6lb 7oz boy who was still quite
jaundice on day 5,his bili was 285 via bilimeter.
I was breastfeeding and the advise given to me by ped on leaving hospital
was feed him 3/24hrly and expose him to the sun for a period of time during
the day.bring him back the next day or so for check bili.

This was what I would have done as the midwife I was at that time,however
back then we also offered our babies under lights in the postnatal wards
extra fluids (sterile water ) if they were being breastfed.However,today we
don't offer extra fluids.We might have a mother express for those that are
severely jaundice so they don't have to come out from under the
lights,bili's come down faster this way then if they are taken out from
under lights and breast fed.

Today's use of Biliblanket and bilibeds has meant that we don't have to put
these babies back into insulcots with banks of lights over them.Mum has easy
acess for breastfeeding,particularly with the blanket method.

It is probable only in the NICU where babies under phototherapy have extra
fluids such 10%dextrose,N/Saline or parental nutrition as well as being
given EBM,these are the samller babies that may not be on full feeds yet or
on antibotics etc.These babies generally take longer for them bili levels to
fall and yes may get rebound,needing to go back under lights.One has to
remember that their internal systems are still immature and not working at
full capacity yet

The larger older babies will probablely be placed on a biliblanket or bed if
they are available.No IV/CVLs unless they have had recent surgery
(gut,cardiac etc)

We have a Jaundice fact form that we give parents to inform them about what
jaundice is and what form of treatment may be used within the ICN/SCN
nurseries.This allows them to have a basic knowledge of what's happening and
what to expect in regards feeding for their baby under phototherapy.

Anne Clements RN EM BNS
Brisbane QLD
Australia

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