Hello all,
Permission to post.
I had an experienced client who got a slow start to (exclusive) bf due to a 2nd surgical procedure after her c/s. The baby lost close to 9 percent and needed home phototherapy for an elevated bilirubin level. She called to reschedule her follow-up appointment but her descriptions of output were not reassuring. Mother was still needing help at home and wasn't sure how many wets and dirty diapers the baby had made. She did report that baby's stools were very dark. Baby also needed a repeat bili level done so I convinced her to come on in. Baby was 5 days old, term infant.
The baby was quite yellow but the bilirubin was down some, he had gained 4-5 ounces overnight (all naked weights), and transferred 64 ml at one great breastfeeding. (I had a nurse training with me in BF Center, so I showed her the pre/post weights). The baby did void and stool x2 in office, the urine was somewhat dark and so was the stool. It was very dark green to black and seedy. The baby appeared well hydrated.
My idea is that either (1) the baby is excreting bilirubin and so the urine and stools are dark. or (2) the baby got a slow start, lost weight initially, rebounded overnite when the milk came in, and is slightly behind schedule in his output patterns. I do not have the medical record, but to my knowledge the baby does not have pathology nor high direct bilirubin. 
My question is do you sometimes see dark urine and stool in jaundiced infants? Level was about 16 mg/dl. Other comments?

Laurie Wheeler, IBCLC, MN, RN
 
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