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Mon, 17 Sep 2007 06:52:49 EDT |
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Natalie writes: ...Have those of you in
practice seen any instance of kernicterus in breastfed infants you were
following? I would appreciate your input on how often you see breastfed
babies develop jaundice that requires intervention (phototherapy), and if
your observation in those babies is that breastfeeding was not going well
beforehand. Have you noticed more physicians advocating supplementation
of casein hydrolysate formula in the last few years since these studies?=20
Thank you for your time and response.
Sincerely,
Natalie Davis
Natalie,
First welcome..it is so exciting to see so frequent posting from Ivy Tech
Student in Indianapolis..My town! and you all ask such wonderful questions.
Second...in a hospital in Indy, we are seeing tons of "high bili's" But I
think your assumption is a common incorrect one...We do not see higher
bilirubins in breastfed babies..we see Lower bili's in Formula fed babies...NOW...is
that normal? Breastfed babies are the physiological norm...so therefore
those higher bili's are assumed to be the physiological norm. My
understanding..both as an RN for 15 years and IBCLC for over 6 is that there is protective
value in a somewhat higher bili at day 1-2-3. I strongly feel we are checking
way to often/early babies and supplementing/scaring parents too early.
Every time we "treat" a 24 hour infant for hyperbili we set off a huge cascade of
events that undermine a mom's ability and confidence to breastfeed.
Lastly, our docs don't recommend a lot of hydrolysate formulas...they just
like any old formula to be shoved down these poor babies throats!..oops getting
testy aren't I.
I would love to speak to you more off list if you have more
questions...Perhaps you can join me at work some day to observe some real breastfed babies
during support group!
Cheryl Parrott RN, IBCLC
Kokomo, IN...working in Indianapolis
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