My name is Jennifer Tieman and I am a family physician practicing in rural Illinois. I have been lurking for a while and was delighted to see a few familar names! I wanted to comment on the jaundice and formula issue. I am new to the area here and find that most of the jaundiced babies I take care of have moms who have heard from someone else that breastfeeding causes jaundice, or that formula decreases bilirubin faster than breastmilk. Most moms are asking me for formula if baby looks a little yellow. I have had success in reassuring moms and preserving the breastfeeding relationship by letting mom know that preserving breastfeeding is a "medical" goal. I tell them that in the long run, baby receives so many benefits from breastfeeding that decreasing bilirubin a little faster is just not worth interfering with breastfeeding. If phototherapy is necessary, I try to use a bili blanket at home. If that is not available and baby must be under lights for a short time, I allow baby to be out as long as needed for breastfeeding. Most of the time we are treating a non-dangerous bili level because we are worried about it getting higher and causing trouble. If baby is receiving some phototherapy and feeding well, bili should stay stable or decrease. Of course there are exceptions, if baby has a cause for pathologic jaundice, or is not feeding well they may need help with feeding issues or more aggressive phototherapy. Our hospital is a community hospital, so I am dealing with primarily healthy term infants, and the occasional near-term premie. Obviously sick or premature infants would have to be treated differently. I think breastfed baby jaundice here is contibuted to by lack of frequent feeds. Our hospital has rooming-in, but the majority of moms choose to send their babies to the nursery at night. Although our nurses bring babies out to be fed, they tend to make sure baby is "truly hungry" before taking baby to mom. Baby may be rocked, patted, or even given a pacifier during all the early cues for feeding, so baby and mom miss out on the opportunity for frequent feeds based on baby's cues. True unrestricted exlusive breastfeeding is pretty uncommon in the town I practice in, and few moms follow my advice for full rooming-in and unrestricted feeding. I haven't figured out yet a way to convince moms to keep their babies close, and that "being used for a pacifier" isn't a bad thing! Jennifer Tieman, MD *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html