Hi Lactnetters.

Just wanted to make some comments about the baby Toby talked about a few
days ago with the bili of 17.

The very first thing to check in a baby who is doing so well is what type
of bili is this.
To do that:
                - Look at the color of the urine: if dark it is a problem
that would mean that the bilirubin is water soluble (direct) and therefor
has been processed by the liver.

                - Have the doctor check a "split bili level" this will
give the proportion of total bili versus direct. For instance a baby who
has a total bili of 17 and a direct bili of 4 or more does not have
breastmilk jaundice but usually another problem with the liver.

It is important to think about that in babies jaundiced beyond 2 weeks of
age because it is important to find the cause of the liver problem.

It can be as simple as a cyst on the drainage system of the bile, a
urinary tract infection, hypothyroidism which are all easy to treat but it
can also be Biliary atresia (obliteration of the ducts draining the liver)
which requires surgery without delay.

So beware!! I would be happy to answer any questions on the topic.

Any lactnetters in the Harlingen (TX) area.  Am flying down there for a
conference  tomorrow.  Always nice to match faces and Email!

Maryelle