To Jan and perhaps other interested parties,

Yes, indeed, it was many years ago that I had contact with my "pumpkin"
baby.  I was working as the night lab technologist at the Kuaikeolani(?)
Children's Hospital in Honalulu and drew this baby's blood when she was
brought into our emergency rrom.  As I recall the mom was a young haole
(white) girl who had little or no prenatal care and no postpartum care
until the visit to our ER.  Don't remember if the baby died, but I think
she did.  Do remember being told soon after the admit that the baby did
not seem to have much remaining brain function, seemed to be blind and
deaf. Indeed when I drew her, there was no response and her eyes were
open and staring.  Have no idea if the baby was being breast or
bottlefed.  Have seen one or two end stage liver patients (adults) who
attained a similar color, but no other babies.

Did not mean to imply that the lactnet  baby had kernicterus, it is
indeed pretty rare these days as I understand it, but the color thing was
a red flag.  It still seems to me that at least one baseline bili level
would be in order here so at least you would know where you were going if
things did not improve or got worse.

To Mary Alice and others with mis-informed pediatricians,
I would direct them to the AAP's own " Practice Parameter on Management
of Hyperbilirubinemia in the Healthy Term Newborn in Pediatrics, 1994
(October), 94:558-561.  Although still a little conservative by some of
our standards, it is a giant step in the right direction for
pediatricians like the one you are dealing with.  Lays out a nice
flowchart to help docs decide what to do next and supports NOT stopping
breastfeeding.

Happy Thanksgiving from Sharon who is wondering why she is reading
lactnet on this holiday morning after working for ten hours - time to go
fall asleep watching the parades.
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