In a message dated 12/10/2003 6:50:03 AM Central Standard Time,
[log in to unmask] writes:
i find one thing most parents are very unsure about is the diagnosis and
treatment of jaundice. i am usually the first one to explain to them what it is
all about.

Ditto....I also frequently get this feedback when I'm teaching about the
physiology of jaundice, the signs and symptoms, such as why the baby is sleepy at
the breast, and the duration of the symptoms, with reassurance that their baby
no doubt will not remain this quiet, little angel for long once we get the
jaundice resolved with adequate hydration.  I find I get more compliance once
moms understand the rationale for hydration of the baby, yes, even
supplementation "temporarily" to resolve the bili issue promptly.  Supplementation method
is mutually agreed upon after offering her choices.

I have more compliance for an effective pumping regime once I've educated on
the infant's ineffective suck (if present), and again, stressing that once
baby's jaundice is resolved and baby's effectively suckling again, the goal of
our interventions or plan of care is to get baby promptly back to breast again.

My most recent jaundice baby is now 6 weeks old.  Mom was switched to an
effective pump to maintain her milk supply, baby was finger-fed to hydration, bili
blanket ordered on day of consult for bili of 18, discontinued the very next
day when bili down to 13, baby still sleepy for 2-3 more days, mom continued
pumping/fingerfeeding, baby still exhibiting inability to sustain latch
approximately 5 days after initial consult, used nipple shield to sustain latch with
insurance pumping and goal to wean off shield within a week, baby showed
inability to grab onto the pacifier for suck-training then, referred to CST, and
baby went to breast after 2 treatments.  Saw mom/baby this week at my support
group and at LLL and they're breastfeeding well.  Oh, by the way baby's no
longer sleepy as you can imagine, and has a double-chin.

Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
St. Charles, IL

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