Hope this generates some discussion among the rank and file: We have had a steady influx of these "slightly underdone" babies lately, and the subsequent jaundice that most often occurs. While some physicians treat them appropriately, ordering phototherapy for sluggish feedings and increasing bili's, others prefer to wait it out even with serum bilirubins of 19 0r 20. Often these parents are home with these babies who are clearly unable to feed vigourously at breast and somtimes even by botlle. Luckily we have good outpatient f/u for breastfeeders but...... After hearing Dr. Gartner's presentation on kernicterus at the AAP, presentation last month in Chicago, we are all very concerned when this occurs. In "thinking outside the box", I know in our NICU, our neo's start photherapy even for the 33-34 weeker almost prophylactically at very low bilirubin values. those babies admitted to newborn however, never get this treatment and are always treated after it becomes a significant problem. We do have an excellent policy IMHO on offering expressed mother's milk feeds fo formula if needed in small amoutns for ineffective feeds as needed. For some of you MD's on the list or even hospital based LC's, are any of you seeing a return to earlier treatment of jaundice in these near term infants who are coming at us in ever increasing numbers? Can anyone think of any reason NOT to treat these little ones fairly early on, especially if it can be provided in the home setting through a bili blanket or wallaby unit. LuAnn Smith RN, BSN, IBCLC Wellspan Health York, PA _________________________________________________________________ Gift-shop online from the comfort of home at MSN Shopping! No crowds, free parking. http://shopping.msn.com *********************************************** 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