Hi.  I am a hospital based lactation counselor and have been "lurking" for a 
while.  I enjoy the posts and have been learning a lot--thank you.  I just 
recently revised our hyperbilirubinemia policy and came across this statement 
in the AAP's "Management of Hyperbilirubinemia in the Newborn Infant 35 or 
More Weeks of Gestation".  In referring to hydration issues, it states that 
the best fluid to use (in mildly dehydrated infants) is a milk-based formula 
because it inhibits the enterohepatic circulation of bilirubin and should help to 
lower the serum bilirubin level.

I remember recent posts on this issue and don't recall that anyone came up 
with good evidence that formula in and of itself can lower bilirubin levels 
anymore than any fluid (especially breastmilk) could.  Did I miss something?  
This statement was not referenced and bugs me--is it true?  One more reason 
for docs to supplement before giving breastfeeding a chance.

Denise Schuler BSN, RNC, CLC
Powell Valley Healthcare
Powell, Wyoming
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307-754-1212

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