Natalie,

Having had two babies myself with very severe neonatal jaundice (we have
many risk factors for this, the biggest being blood type incompatibility
between my husband and me and a positive Coombs antibody in both me and my
babies after their births...if you look on the Bhutani curve for risk of
kernicterus, you can see my first baby was almost off the chart, with a
bilirubin of 21.7 at 18 hours old...this is not what most people will
normally see, this is abnormal), I do know a bit about this topic.

I would have to say that there is nothing in human milk that perpetuates
jaundice; the agent that must be present to rid the body of bilirubin is
protein.  This is why glocose or water supplements are futile (and harmful,
because they take the appetite away) in jaundiced babies.  The problem,
then, isn't the milk itself but whether the baby has access to it.  In the
case of my first baby, she nursed well after delivery, then fell asleep, not
to wake again on her own, and once she was awakened, she was too lethargic
and hypotonic to even begin breastfeeding (my one flat and one inverted
nipple didn't make matters any better for her).  A supplement of human milk
through an easily accessed feeding vessel (syringe, cup, etc.) would have
been the ideal fix -- the protein in the human milk would have gotten into
her body and the bilirubin could bind to that protein and she could pass it
through her bowel movements.  Instead, she was bottle-fed formula; this and
the phototherapy did save my girl from kernicterus but it also set her up
for a lifetime of food allergies (we can't leave home without an epi-pen)
and severely jeopardized our breastfeeding relationship (I would not take no
for an answer and she finally breastfed after 6 days of bottles).

My son was born at home, not separated from me for a minute, breastfed like
a champ from the word "go."  Again, take out your Bhutani curve and see that
my son was also in serious straits, with a bilirubin of 14.7 at 30 hours old
(hemolysis also alarmingly high).  The fact that breastfeeding got off to
such a fabulous start, plus my awareness that we might need phototherapy
early on (I took him in for a bili check at 30 hours old on my own)
prevented Simon from ever falling into that sleep and lethargic state Anna
did.  He continued to breastfeed on demand and get everything his body
needed to excrete the bilirubin.  Formula was unnecessary because he had
access to my milk, which came in much faster the 2nd time around and I knew
what I was doing as far as latch, etc. were concerned.  He spent less than
24 hours under the lights; Anna was in the isolette under the lights for
several days.

Perhaps someone will correct me here but I think the bottom line is that
formula is never "necessary" when treating a jaundiced baby, unless it is
the only readily available protein source.  In environments where human milk
(banked or otherwise) is the supplement of choice, it does as well or better
to help the baby rid his body of the bilirubin, without increasing the risk
of allergy, etc. like a cow's milk or soy formula can do.

Good luck as you continue your studies,

--Diana in NY

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]