Deleted the post on this so can't refer to specifics.  Jaundice caused by
ABO incompatability is a little different from what we call "normal
physiologic jaundice" in that it is a pathologic condition caused by the
destruction of the babies red cells by antibodies produced by the mother
(usually the mother is an 0 and the baby an A).  In this scenerio, the
bilirubin count may rise more rapidly and may require a bit more
aggressive treatment, although ABO problems are usually not of the
severity seen with Rh incompatabilities.  I would advise the mom to
really concentrate on frequent, early feeds which will help to move the
meconium out and eliminate bilirubin through the stools.  If push came to
shove, I would rather see a baby under bili lights for a day or two
(while contintinuing to breastfeed) rather than supplementation with ABM.
 If supplementation does become a reality, it should be in addition to,
rather than instead of, breastfeeds.  If there is any history of
allergies, colic, asthma, etc. on either side of the family, in the case
of supplementation, I would insist on the use of banked breastmilk or a
pre-digested formula such as nutramagen to lessen the chance of
sensitization.  Formula supplementation due to jaundice is what started
my son on a long and very uncomfortable path of multiple food allergies,
severe eczema and eventually asthma.  Hope this helps.

Sharon Knorr, BSMT, LLLL, IBCLC
Lactation Consultant Services
Rochester, New York
mailto:[log in to unmask]

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