<<Does anyone have hard data on the proportion of term newborns who get
phototherapy for pronounced physiologic jaundice in the US?  Any other
countries?  Also, are there standards for threshhold values, or does it vary
from unit to unit?  If there are standard threshhold values, what are
they?>>

Rachel, according to the new guidelines put out by the American Academy of
Pediatrics, 2004, they are sorting babies into 3 risk categories: lower risk
(>38 weeks at birth and healthy), medium risk (>38 weeks with risk factors,
or 35-36 6/7 weeks at birth and healthy) and higher risk (35-37 6/7 at birth
with risk factors.) 

A "major risk factor" includes significant bruising, exclusive breastfeeding
(with feeding problems/excessive weight loss), previous sibling needing
phototherapy, and other factors.

The March of Dimes has concluded that "Inductions may contribute to the
growing number of babies who are born "late preterm," between 34 and 36
weeks gestation. While babies born at this time are usually considered
healthy, they are more likely to have medical problems than babies born a
few weeks later at full term (37-42 weeks)."

Typical American babies are induced by 37 weeks, and this is causing an
increase in bruising (baby/mother are not ready for birth, forceps/vaccum
delivery causes bruising), feeding problems (young babies don't feed well)
as well as the previous sibling "needing phototherapy" because of the
factors as well ("My last baby was induced at 37 weeks, I want this one
then, too")

I feel the "new guidelines" are very aggressive, and we have a number of
babies "needing" phototherapy. Add to this the incredible bowel movements of
the babies fed DHA/ARA formulas, and the "normal breastfed baby" is suddenly
not having enough bowel movements, or is somehow "impaired."

I hope this isn't the way around the globe!

Best wishes,
Sam Doak

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