Well Lactnetters,
I am rather intrigued in the last week I have had two or three babies come
in to the Mission hospital,Pakistan from Doctors and through OPD for
Phototherapy. On enquiring of mother I am informed their was no SBR or Hct
done . And Rx is for one hour under lights, Please Sister!
Last weeks little bub had a SBR of 9 and screamed the place down when naked
unless attached to the breast which he drank from for most of the hour. I
set mum under the side so he was on her lapunder the lights as ordered.
Now, my question is,- how long exposed does the Phototherapy take to work. I
would have thought a burst of morning sun-bath and evening sunbath would
have been more satisfactory or is it fund raising!
Regards,From sunny very dry dusty (can't see the mountains today)Quetta,
Robyn J Aulmann, RN RM

-----Original Message-----
From: Linda Madsen [mailto:[log in to unmask]]
Sent: Wednesday, 4 October 2000 12:19
Subject: Hyperbilirubinemia


Helen--

I am left wondering why the doctor even started phototherapy for a bili of
11?  It seems around that point is where we stop phototherapy.  What was the
baby's weight?  Was he/she premature?  What was the hematocrit? Was the baby
showing signs of dehydration? Even if we get a baby in for phototherapy
after being home for several days, it will depend on the
hydration/nutritional status of the baby whether or not we supplement the
baby.  Our doctors are getting good at ordering a lactation consult quickly
to help determine if there is anything that needs to be corrected regarding
breastfeeding. Early phototherapy may be started if the rate of increase in
the bilirubin is excessive & the baby shows significant bruising or there is
an ABO incompatibility.  Also, you mentioned that baby & mother were the
same blood type & coombs negative, yet in the last sentence mentioned that
the doctor diagnosed an ABO incompatibility?  None of it seems to add up.

Linda Madsen, RN, CPN, IBCLC

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