I have a situation that I am too invloved in to think rationally and need
some fresh insight!  Permission to post has been obtained from the mother.

My daughter gave birth on 4/25. Baby was full term and weighed 8lbs 14oz.
Within 36 hours the baby was looking jaundice, bili 11.5.  Photo therapy
was started with overhead lights.  24 hours later the bili was 12.5,
despite nearly 18 hours of phototherapy.  Baby was discharged home on a
biliblanket.  On day 4 he had a bili of 20.2, still on a biliblanket.  Day
5 (today), the bili is 19.3, weight check of 8lbs 9oz.  All along the baby
has been nusing well, with audible swallowing.  Stool and urine pattern
GREAT!

History significant for 1st baby having a similar pattern of janudice,
peaking at 22 on day 4 and reamining somewhat jaundice for about 6 weeks

The pediatrician has been stepping lightly around the breastfeeding issue
as she is a family friend and knows that I am working with my daughter.
However, today she referred them to a neonatologist as an outpatient.  The
nenatologist ran blood tests and decided that there was probably some ABO
incompatability going on (positive coombs today, though was not so at
birth)...but retic count was not grealty eleveated so also thought the
breastmilk may be a factor.

Because of this, the neonatologist wants her to stop nursing for 24
hours....I am assuming this is for a diagnosis.    My daughter is very
upset...baby has not had any formula up to now and 1st baby had milk
allergies.  She states that even if it IS her milk she wont stop
breastfeeding...so whats the point of this 24 hour breastmilk free
test...other than to say hmmmm its the milk?   I told her to keep nursing
and have the bili drawn tomorrow as planned....but also told her that I am
too involved and needed further opinions...hence lactnet friends...what say
you????

Lori Peters IBCLC
Kenosha WI

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