The diagnosis was ABO incompatibility.  The diagnosis was *not* breastmilk
jaundice, or even ABO incompatibility *and* breastmilk jaundice.

Personally I would make a big issue with the NICU about *no breastfeeding*.
They had no right, especially before getting back the test result.  What the
**** was the hurry to get the baby to drink formula?  As if it were a
question of life and death?  How long does it take to get a bilirubin back
at this NICU?  2 hours?  3 hours?  Ya mean dey couldn't wait ("This is an
NICU, we shoot first, ask questions later", which is why, incidentally, I
hated working in the NICU)?  The baby had an IV after all, so let us say,
for the sake of argument that the baby was dehydrated from *not*
breastfeeding.  Could still wait.

The treatment for breastmilk jaundice is continued breastfeeding.  Because
breastmilk jaundice is benign, and personally I have never seen it go to 24
mg%.  Actually, those who have heard me speak on jaundice know that there is
no such thing as breastmilk jaundice.  What there is is "absence of jaundice
in formula fed babies", or Formula feeding anicterus, in medical terms.

Jack Newman, MD, FRCPC

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