Natalie writes: ...Have those of you in practice seen any instance of kernicterus in breastfed infants you were following? I would appreciate your input on how often you see breastfed babies develop jaundice that requires intervention (phototherapy), and if your observation in those babies is that breastfeeding was not going well beforehand. Have you noticed more physicians advocating supplementation of casein hydrolysate formula in the last few years since these studies?=20 Thank you for your time and response. Sincerely, Natalie Davis Natalie, First welcome..it is so exciting to see so frequent posting from Ivy Tech Student in Indianapolis..My town! and you all ask such wonderful questions. Second...in a hospital in Indy, we are seeing tons of "high bili's" But I think your assumption is a common incorrect one...We do not see higher bilirubins in breastfed babies..we see Lower bili's in Formula fed babies...NOW...is that normal? Breastfed babies are the physiological norm...so therefore those higher bili's are assumed to be the physiological norm. My understanding..both as an RN for 15 years and IBCLC for over 6 is that there is protective value in a somewhat higher bili at day 1-2-3. I strongly feel we are checking way to often/early babies and supplementing/scaring parents too early. Every time we "treat" a 24 hour infant for hyperbili we set off a huge cascade of events that undermine a mom's ability and confidence to breastfeed. Lastly, our docs don't recommend a lot of hydrolysate formulas...they just like any old formula to be shoved down these poor babies throats!..oops getting testy aren't I. I would love to speak to you more off list if you have more questions...Perhaps you can join me at work some day to observe some real breastfed babies during support group! Cheryl Parrott RN, IBCLC Kokomo, IN...working in Indianapolis ************************************** See what's new at http://www.aol.com *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]