Wendy, depending on what this baby's current weight is, I would also 
encourage mom to protect her milk supply. If baby has lost a lot of 
weight (over 7%) and is not gaining with just breastfeeding, mom might 
need to do some pumping with a good rental type pump (if she can get it) 
after every nursing session to help increase her milk supply and to use 
as supplement if baby is not nursing well due to the sleepiness from 
jaundice. The more the baby eats, the more alert the baby will be. Very 
sleepy babies often do not suck well. Watch for active sucking (10+ 
sucks in a row before pausing), eyes open with good milk flow, arms and 
hands relaxing, and baby comes off breast by himself. Bowel movements 
should be 3-4 large and yellow per 24 hours if just breastfeeding. If 
giving formula, the amounts and texture change and you can't count them 
like with exclusive breastfeeding. If baby has not lost much weight to 
begin with, and now is showing weight gain, and mom is not using 
formula, time will help. Skin to skin is helpful but more may be needed 
with a baby who is not transferring milk well.

Kathy Eng, BSW, IBCLC

 

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