My name is Kyra Torgerson and I am a junior nursing student at the University of North Dakota.  I have subscribed to this listserv because of my interest in becoming a Midwife.  I am currently enrolled in a childbearing class and we have been discussing breastfeeding and infant illnesses.  We are mainly stressed in this class that “breast is best,” it provides adequate nutrients, is easily digested and absorbed, is convenient for the mother, and costs less for families.  Breast milk requires no preparation and is always the perfect temperature for the child.  It helps act as a defense mechanism too.  But in order for any of these measures to be useful we have to make sure that the milk is delivered properly to the infant.  Breastfeeding management includes feeding the infant in the first hour after birth, followed by ten to twelve feedings per day for the first one to two weeks.  There also needs to be proper attachment and suckling too (Gartner, 2001).  If this protocol to h
ealthy breastfeeding isn’t followed, jaundice may develop.

Jaundice occurs in most infants because their liver isn’t mature enough to metabolize a molecule called bilirubin (APA, 2004).  Babies are born with a generous supply of red blood cells, over time however they breakdown, forming bilirubin.  These infants have more bilirubin than their liver can handle, which causes their skin to turn yellow.

This is an intake issue; depending on the amount of breast milk the infant receives influences if a child’s bilirubin levels will rise.  If they raise enough, jaundice could occur.  If bilirubin concentrations are between the levels of 340 and 425 um/l some clinicians feel that breastfeeding should be stopped for 24-48 hours and formula should be used for these jaundice infants (Gartner, 2001).  Others feel that breastfeeding can and should be continued with out interruption unless there is severe hyperbilirubinemia (APA, 2005).

My questions are what is your agency’s policy on breastfeeding an infant with jaundice and as a nurse are there anyways we can make sure the mother has adequate milk for her infant to avoid jaundice.

Thank you,
Kyra Torgerson

(APA, 2005). Breastfeeding and the Use of Human Milk.  February 115: 496-506.

(APA, 2004). Clinical Practice Guideline: Management of Hyperbilirubinemia in the 

Newborn Infant 35 or More Weeks of Gestation.  July 

114: 297-316.

Gartner, L. (2001).  Original Article Breastfeeding and Jaundice.  Journal of 

Perinatology, 21: S25-S29. 
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