Hi. This is one of those cases where "You think you know what should have been done, but not confident enough to express yourself because you think that maybe in this case you would be wrong". We had a 38 week, 7 lb. 6 oz. healthy baby boy who had a bili of 17.4 on 2nd day. Nurse said she wasn't suprised because baby had a large bruise. Breastfeeding was slow on first day, but mom was very patient and as usual things picked up by second day. Baby was stooling well from birth. I watched baby at breast and heard swallowing. I was told baby was to be started on lights (we have the Medela bili bed). I came in next day and was told that baby has been finger fed formula after every breastfeed because bili went up to 20 (it is now back to 18). Baby was wanting to be held and nurse frequently so it was hard to keep him on the lights. I was also told that baby was not latching well and mom's nipples were torn up. Went to talk with mom and she had a different story. Yes, her nipples were sore at latch and did not look good but nursing was not that painful. She also said that she felt baby was breastfeeding fine it was the nurse that was impatient with baby. Her breasts are filling. I watched baby at breast. It took some work to get him on (pacifier was started to keep him happy in bili bed and of course the continual finger feeding probably didn't help). Her milk letdown and I pointed out how his suck changed to a long draw and swallowing increased. He was at the breast for a good 30 minutes and breast compression really increased the swallowing. He accepted no formula supplement after this feed! Mom was very encouraged. I assumed that the formula could be discontinued now that her milk was increasing. Wrong! I came in the next day and he had been given more supplements and I asked mom about this and she said that because he is now fussy at latch the nurse was not patient with him and was quick to supplement. By this time mom was tired and told the nurse to go ahead. Bili is 16 now and baby is being discharged with bili blanket. Mom's breasts are full and she is ready to go home! She plans to work with breastfeeding at home, feeling confident that once she can relax and not have people breathing down her neck she will be able to focus on breastfeeding. I know this is long, but was the formula neccesary at all? Parents did not want to start pacifier, but they could not hold him. Breastfeeding was just starting to go so well until all of this happened. If I would have known about the supplements I would have encouraged mom to use a pump and use her own milk. Dad hit the nail on the head when he said, "It is weird, everything you read and hear says that breastmilk is the perfect food for your baby, but when things go wrong then it is not so perfect anymore and formula becomes the food of choice." I feel this should have been handled much differently, but I am "afraid" to say anything. I need some encouragement! I avoid conflict, but I need to start speaking out. I love the phrase, "A turtle can't move forward unless it sticks out its neck"! I am so tired of the idea that if everything is going well then breastfeeding is fine, but if not then you need to use formula. I am sure this is a common scenario for many of you. Thank you for listening. Does anyone have any suggestions on how to keep baby happy while in bili bed without using a pacifier? It seems to be a catch 22 because if baby wants to nurse frequently then this is good, but then baby is not on the lights as long. Christine Lichte LLL Leader, IBCLC Warrensburg, MO *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html