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Subject:
From:
"Elisheva S. Urbas" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 24 Nov 1998 17:38:59 EST
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Thanks again to all who advised on my baby who nursed all time he was awake at
day 5.   I saw him again today, at 8 days.  With positioning improved he still
nurses nearly all the time and at length but has increasingly more wakeful
moments here and there and seems more alert and his little hands are already
less wrinkly-skinned.

However, he presents me with a new, partly academic, question.  Today he is
yellow as a school bus, and late this afternoon while he was sleeping his
father (a doc) noticed some sparkly little bilirubin crystals in the dried
sweat on his forehead.   His pediatrician (immediately called, natch) was not
concerned -- "as long as he's doing everything else he's supposed to be doing
I'll see him next week as planned."

So here's my question.  First, this qualifies as late onset jaundice, yes --
onset in second week?   Assuming yes, I read in the brown bible (p384) that
one suspected cause of this is higher-fat milk of some moms -- hence expected
in subsequent bf children of same mom etc.    But do we think that this baby's
feeding pattern -- on the breast most of his waking time, eg both very long
and very frequent feeds -- is tending to be higher in hindmilk and
consequently "making" higher fat milk and consequently more bilirubin?

If this is correct, are there any suggestions one could make to the mom that
might decrease this pattern?  I so far have not thought of any, since it is
counter to my intuition to say that she should think of nursing him any less
-- am I right here?  And if I have the hindmilk/fat/bilirubin thing wrong,
thanks in advance for helping me with the physiology here, which as you can
tell I am struggling to learn and understand.

Working the brains hard, Elisheva Urbas in NYC

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