Diane hi i am up too late due to coffee and tomorrow is jcaho assessment. oh well diane you ask about bili levels. my lab chart says total bili 2-6 mg/dl (<24 hrs); 6-7 (48 hrs); 4-12 (3-5 days) and it doesn't go further than that. anyway 13 at day 10 is high. why is it high? is the baby feeding poorly? it would seem so based on your descriptors: "has 'fair' poopie diapers, sleeps 5 hours at night, the client has raw nipples and has started to use a nipple shield at night to protect her nipples a little from sloppy latch; The baby nurses for 10 minutes at a time." Diane, if the baby were thriving i wouldn't mind a 5 hr sleep, nor a 10 min feed, however the feeding sounds problematic. what is the weight? i'd really want to know this? what is fair poopie? most thriving bf babies are pooping ALOT at this point. what is moms' milk supply like and how was it at onset of copious production in early days? also, are there any factors to contribute to bili production like ABO incompatibility, bruising, i.e. some pathology? it sounds like this dyad need some serious bf help asap. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ Chat with friends online, try MSN Messenger: http://messenger.msn.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html