A word of caution on using sunlight for treating jaundice....

I did this with my first child.  We lived in Hawaii.  He was a little sleepy, but seemed to be nursing fine.  When his blood level was checked two days after we went home, it was 19.5.  That is very high.  He was readmitted to the hospital where he had to endure a complete sepsis workup (blood cultures, spinal tap) and was then put on an IV, formula and phototherapy.  We never really knew why it was so high.  We had incompatible ABO blood types, but no DAT was done, so we'll never know if that was a factor.  Maybe he was not really nursing as well as I thought.  Anyways, I would have been better off staying in the original hospital and doing a day or two of phototherapy to get the levels down before we went home.

Another story.  Young mother comes to our Emergency Room with an orange baby.  Kernicterus has already set in.  Permanent brain damage.  Very sad.  First-time mom didn't know the difference between being a little yellow and being orange.  And very sick.

Moral of the story.  High bili levels are nothing to fool around with.  If you are going to do the sunlight thing, make sure that bili levels are checked daily.  If baby is getting a lot of formula (as in the case of the adoptive mother), then it is likely that the levels will come down pretty quickly.  If mom is breastfeeding, it is not as easy to tell how much baby is actually ingesting.  I have seen a lot of unnecessary formula feeding, weaning, etc., because of low bili levels that just needed a few hours of phototherapy to come down.  I also drew blood on that poor little orange baby who stared into space with unseeing eyes.  There is always another side to the story.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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