A few weeks ago a mother who had a bile duct stone called me because, as
usual, everyone was telling her it was a problem that she was so jaundiced,
and that her milk would pass bilirubin onto the baby.  My response, as
usual, was "so"?

To elaborate a little, I told her this seemed unlikely, because if there was
significated elevated bilirubin in her milk, her milk would appear yellow.
And even if the milk did have bilirubin in it, I could not see how this
would be a problem since the baby has plenty of bilirubin in his gut anyway
from his own liver.

I suggested she get her milk tested for bilirubin, since they were going to
do her blood work anyway just before the procedure to break the stone, which
she did.  I got the result today.

Her serum bilirubin was 96 micromoles/L (for the SI-ly challenged, that is
between 5 and 6 mg%).  Her milk bilirubin was 5 micromoles/L (about 0.3
mg%).

One can quite reasonably argue about how accurate the test is when the test
was not made for measuring bilirubin in milk.  To which I answer again "so"?
She kept breastfeeding, that was the main thing.

Jack Newman, MD, FRCPC