I was at the hospital with a client and her baby because I had had a
preview with her. On day 3 baby was a bit jaundiced.  The nurse came in and
told her that the baby was jaundiced with a bilirubin count of 12. She had
notified the ped and would wait his recommendation before treating.  She
said that the bili should be zero.

Being the respectful LC in private practice who happened to be in the
hospital at the request of the mother, I didn't say anything until the
nurse left.  Then I reminded the mother of what I had told her before the
baby was born.  I knew that her Ped is one of the "good guys" and would not
even blink at a 12.  He tells a mother with a "yellow" baby on day 5, that
the bili peaks then and will begin to go down.  This is after noting plenty
of bowel movements of "proper" color. He does few heel sticks and has
confidence in his knowledge of breastfeeding--as do I.

I have wondered if I should do anything about the lack of knowledge of
appropriate bilirubin levels in this nurse, who is most likely not alone in
her belief that the level of a baby on abm is the normal level. This
hospital has a full time LC who has worked hard to educate but who still
has staff who say what they have always said.

If I hadn't been there to assure this mother that her baby was reacting
healthifully to her baby's slow start at efficient breastfeeding, she would
have thought that she had a "sick" baby.  He is a 12, when he should be a 0!!!

Pat Gima, IBCLC
Milwaukee, Wisconsin
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