An earlier post asked about breastfeeding jaundice and hospitals changing
their practices to decrease the risks thereof.
I appreciate the responses about formula fed babies having too low bilirubin
levels, and breastfeeding of course being the gold standard.
However, I do want to address hospital practices. At the hospital where I
work, we have done some things differently, the goal being to help mothers
achieve
"successful lactation" and to avoid adverse events like kernicterus (rare
but does occur), and to avoid need for re-hospitalization or even home
treatment of hyperbilirubinemia.

The main problem with breastfeeding and jaudice, as I see it, is some babies
are not feeding EFFECTIVELY, and therefore it is the LACK of breastmilk that
is giving them excess levels of bilirubin. I have seen a huge increase in
the number of preterm and near term infants who go home on the same time
frame as term well babies, and were not feeding well in hospital and then
fail to feed effectively at home.

Some of the things that can and should be implemented, in my opinion, would
be:
Skilled staff to assess baby's feeding effectiveness and to help mom/baby if
needed - improving latch, breast compression, pumping, etc.
Uninterrupted skin to skin contact and no restriction of time at breast.
Early follow-up at around day 3 to 5, to assess for milk surge, feeding
effectiveness, baby weight, and very high bilirubin levels.
Awareness of risk factors, nurses to assess for these, and follow-up: blood
type incompatibility, prematurity, near term infant, infant sick at birth,
delayed feeding, bruising (an infant who will be the one to need treatment
for hyperbilirubinemia is the preterm baby who was fed IV first day or two
and has some bruises, for example, or even a term baby who had a difficult
birth with some trauma and he didn't feel like eating the first day).
Adequate teaching for parents regarding risk factors, expected feeding
patterns, expected output, and need for followup.

Hope this is helpful to the original poster.
Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI USA

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

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]