Hi Netters,

It always stirs things up in me when I read about jaundice, phototherapy, and
BF.  I use to run Medela, Inc. Home Phototherapy Program, nationally.  I
would certify and set up individual RNs (many IBCLCs) to run their own
private home phototherapy business.  I  ran a phototherapy business for 10
years.  My maddness for doing this was to get in the backdoor and have
qualified nurses that were educated in lactation treating jaundice baby's and
getting them off to a good start with breastfeeding.  What I found is that as
soon as you got these babies nursing, feeding and stooling the bili's would
go right down.Yes, we did have those vaccum extraction/forcep babies that
took alittle longer, but NONE needed to be taken off breast.  Towards the end
of my practice, Drs. were not treating, in this area, until bili's were 18 or
above (normal physiological jaundice).  People talk alot about natural
sunlight vs phototherapy.  Problem with sunlight is that you have to chase it
around to make sure infant is always exposed and it ends later in the day.
 You also need to monitor infants temp and hydration conti.  I would utilize
the sun by wrapping infant in the biliblanket and sitting kido in infant seat
exposed to sun (double phototherapy).  Those bili's would come down so
rapidly.  It always fasinated me that when I would test the irradiance of the
biliblanket or phototherapy unit it would be 8-12, even though the blankets
will go 25-35 now.  You measure the sunlight's irradiance, that is the
measurement of the blue spectrum wavelength which should be 425-475
nanometers, would be 35 or above (microwatts/cm2/nm).  In regards to retinal
damage or someone else mentioned color damage, the study they used to show
how the blue light effects the retina is by using pigs, prying open their
eyes and have them stare into the lights for many hrs.  Of course they are
going to have damage.  Look at the sunlight for that long and you too can get
retinal damage.OK, I will get off my soapbox.  It is cloudy here In the
Chicago area today, bad day for sunlight phototherapy.

Pat Bull RN, IBCLC
The Breastfeeding Connection, Medela
Naperville, IL