Hi,

I'm so sorry to whoever posted the initial request.  I didn't save your note.
I didn't plan to respond, but I got more and more annoyed as I thought about
the attitude of that doctor.  So, I did a search of the AAP and Pediatrics
site (in all this spare time of mine  :-D).

I put in links for the documents that had the abstract/policy on the web site,
and the citations if it didn't.  The website only had the abstracts, not the
whole article.  The first link is for hyperbilirubinemia management
recommendations followed by a specific quote from that document that addresses
your question directly.

This lack of minimal knowledge about a basic issue of newborn care (I read
while searching that approx. 60% of term newborns are jaundiced) just makes me
crazy.

I really have to give you a lot of credit for keeping your cool, too.  You
kept the door open to supply him with information.  Let us know how it goes
when you give him more information.  I will go calm down now, so here's the
info:

Karen Seroussi, LLLL
Norwich, CT


 <A HREF="http://www.aap.org/policy/hyperb.htm">AAP - Practice Parameter:
Management of Hyper...</A>

Treatment of Jaundice Associated With Breast-feeding in the Healthy Term
Newborn

"The AAP discourages the interruption of breast-feeding in healthy term
newborns and encourages continued and frequent breast-feeding (at least eight
to ten times every 24 hours). Supplementing nursing with water or dextrose
water does not lower the bilirubin level in jaundiced, healthy, breast-feeding
infants.[31]  [emphasis added]   Depending on the mother's preference and the
physician's judgment, however, a variety of options are presented in Table 3
for possible implementation beyond observation, including supplementation of
breast-feeding with formula or the temporary interruption of breast-feeding
and substitution with formula, either of which can be accompanied by
phototherapy."



<A HREF="http://www.pediatrics.org/cgi/content/abstract/89/5/809?terms=physiol
ogic+jaundice&searchqstr=tyear:1998!fyear:1975!fmonth:Jan!tmonth:Jan!tdatedef:
1+January+1998!fdatedef:1+January+1975!hits:10!sendit:Search!titleabstract:phy
siologic+jaundice">Pediatrics Abstracts -- Newman and Maisels 89...</A>


<A HREF="http://www.pediatrics.org/cgi/content/abstract/91/2/470?terms=physiol
ogic+jaundice&searchqstr=tyear:1998!fyear:1985!fmonth:Jan!tmonth:Jan!tdatedef:
1+January+1998!fdatedef:1+January+1975!hits:150!sendit:Search!titleabstract:ph
ysiologic+jaundice">Pediatrics Abstracts -- Martinez et al. 91 (2...</A>

TB Newman and MJ Maisels
Response to commentaries re: evaluation and treatment of jaundice in the term
newborn: a kinder, gentler approach
Pediatrics 1992 89(5): 831-833.



AK Brown, DS Seidman, and DK Stevenson
Jaundice in healthy, term neonates: do we need new action levels or new
approaches?
Pediatrics 1992 89(5): 827-829.


LM Gartner
Management of jaundice in the well baby
Pediatrics 1992 89(5): 826-827.

(sorry I must not have highlighted the authors when I copied this)
Inadequate breast feeding and jaundice
Pediatrics 1990 85(5): 892-894.