Rachel Myr writes:  "We don't ever, ever, ever send a jaundiced baby home with
no planned follow up within a safe amount of time, and parents know what to
get alarmed about, in which case they get in touch."

Unfortunately, in the USA many moms are sent home less that 48 hrs postpartum with little or no follow-up other than an appointment with a ped in a couple of weeks.  After many years of overtreatment of jaundice, often to ridiculous lengths, in the last few years many docs suddenly became quite unconcerned about signs of jaundice in the babies that were released from the hospital.  These moms went home with few guidelines and often the moms with breastfeeding babies had no follow-up to ensure that infant intake was adequate.  Somewhere along the way, kernicterus began to show up again, mainly in breastfeeding babies, or should I say, babies who were not breastfeeding very well.  So now we are beginning to see things swinging back again to a very conservation approach in some circles.

My point is that a lactation consultant or La Leche League Leader with a lack of experience with jaundiced babies could make a big mistake if she advises a mom to simply put the baby in a sunny window every day and wait for the jaundice to go away.  If the mom is not being followed by a physician or clinic as well, and if the LC and/or mom misjudges the degree of jaundice, there could be a problem.

Of course, this all goes back to the question of adequate follow-up for new moms during the first week or two when so many problems crop up and need to be addressed immediately, whether to follow a jaundice concern or to resolve breastfeeding issues which could lead to early weaning if not handled in a timely manner.  The fact is that too many moms in my country have NO safety net, let alone multiple ones.   Readmissions are so costly.  One would think that not only physicians but also medical insurers would see that lack of follow-up care is penny-wise, but pound foolish.

Thanks to Linda and Rachel for the very "cool" info on wavelenths :)

Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

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