mommyoftwinboys Posted June 7, 2011 Share Posted June 7, 2011 I always love to get info from you ladies, so here it goes... My 4 week old baby has jaundice. He was 3 weeks early. No complications in the hospital, biirubins were 5 lwhen we checked out. I had him checked about 4 days later with a GP. She said he appeared slighly jaundice, no big deal just sit him by a window. Fast foward 3 weeks, and I notice his eyes are kindof yellow. We brought him to the doctor on Monday and she didn't seem overly concerned but decided to run some blood tests. His bilirubins are at 12.7, direct is 0.3, she had me stop breastfeeding for 48 hrs to see if it's breastmilk jaundice. Has anyone had any experience with this? She said his CBC came back normal, but they are going to redo it on Thur. I'm freaking out something is wrong with my baby... Quote Link to comment Share on other sites More sharing options...
justamouse Posted June 7, 2011 Share Posted June 7, 2011 Yes, one of my twins had to get light treatment for a few weeks because of it, and she was 6 weeks early. Make sure you keep pumping so that milk keeps flowing. Though my Dr told me to keep BFfeding, but from a bottle to make sure I had some measurements of how much she was getting, we still supplemented and went for treatment. Her eyes did get pretty yellow, too. :grouphug: Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 7, 2011 Author Share Posted June 7, 2011 thank you for responding..do u happen to remember her bili levels? Quote Link to comment Share on other sites More sharing options...
ktgrok Posted June 7, 2011 Share Posted June 7, 2011 http://www.nbci.ca/index.php?option=com_content&view=article&id=79:breastfeeding-and-jaundice&catid=5:information&Itemid=17 I wouldn't stop nursing. That is outdated advice. Quote Link to comment Share on other sites More sharing options...
justamouse Posted June 7, 2011 Share Posted June 7, 2011 (edited) I'm thinking 11 or 12? That was 9 years ago, though. I honestly don't know if anything in treatment has changed since then. But, like I said, my Dr basically wanted me to flush her out. I had a lot of milk so I would fill bottles up and we fed her All. The. Time. She also was so teeny she needed the calories, too, but that kid always had a bottle or me in her mouth. Edited June 7, 2011 by justamouse Quote Link to comment Share on other sites More sharing options...
Heather in OK Posted June 7, 2011 Share Posted June 7, 2011 http://www.nbci.ca/index.php?option=com_content&view=article&id=79:breastfeeding-and-jaundice&catid=5:information&Itemid=17 I wouldn't stop nursing. That is outdated advice. :iagree: http://www.breastfeedingbasics.com/html/jaundice.shtml There has never been a case of kernicterus associated with this type of jaundice, or any detrimental after effects. Because we know the well-documented benefits of breastfeeding, the baby should not be denied the advantages of breastfeeding, given the fact that the slightly elevated bilirubin levels will soon return to normal levels without any intervention. Once pathologic causes are ruled out, nursing should continue. Sometimes babies are taken off the breast for 24-48 hours just to make the diagnosis of breast-milk jaundice, though this is seldom necessary. If your healthcare provider wants to go this route, and the levels drop significantly, then breastfeeding should be resumed. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted June 7, 2011 Share Posted June 7, 2011 Here is another article, from Medline. They say to nurse MORE often, not less. In fact, if the levels are under 20 it says you don't need treatment at all. Please don't stop nursing, this is prime time to end up with nipple confusion...you might have a lot of difficulty getting the baby back on the breast. http://www.nlm.nih.gov/medlineplus/ency/article/000995.htm Quote Link to comment Share on other sites More sharing options...
maggie10 Posted June 7, 2011 Share Posted June 7, 2011 Please call a La Leche League leader or lactation consultant. If you do decide to use formula, consider using a dropper or cup to feed the baby. It can help prevent nipple confusion. Also, don't forget to pump! You're still establishing your milk supply. I hope it all works out soon! Quote Link to comment Share on other sites More sharing options...
justamouse Posted June 7, 2011 Share Posted June 7, 2011 My kids must have been strange, they never had nipple confusion. Quote Link to comment Share on other sites More sharing options...
indigomama Posted June 7, 2011 Share Posted June 7, 2011 (edited) DD came very fast and had some major bruising. At 48 hours old her level was 13. We were readmitted to the hospital for 24 hours of lights. When we left her level was 22. The Dr told us the numbers would go up but that she was older so it wasn't as big of a deal. We had it checked every 48 hours for a week and had to keep her in as much indirect sunlight as possible. I've never heard of breastmilk causing it though. In fact our PEd told me to nurse her as often as possible as it would flush out her system faster. Sorry, I'm not much help but your numbers don't sound too high given the age of your little one. Edited June 8, 2011 by indigomama Quote Link to comment Share on other sites More sharing options...
Mrs Mungo Posted June 7, 2011 Share Posted June 7, 2011 Breastmilk jaundice is a misnomer and an outdated term. I agree with everyone else, nursing more frequently will help. Set an alarm for every two hours and try to nurse. Quote Link to comment Share on other sites More sharing options...
LittleIzumi Posted June 7, 2011 Share Posted June 7, 2011 http://www.nbci.ca/index.php?option=com_content&view=article&id=79:breastfeeding-and-jaundice&catid=5:information&Itemid=17 I wouldn't stop nursing. That is outdated advice. :iagree::iagree::iagree: My pedi had me actually nurse baby when he was sleeping (waking him just enough to latch on) to get extra breastmilk in him to flush out the bilirubin, plus extra sunlight. Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 7, 2011 Author Share Posted June 7, 2011 Thank you for all the replies so far. The doctor wanted to do it this way to confirm it was breastmilk jaundice and not something else. She has me coming back on Thur. for another bili check, CBC, and liver function test. I was so scared, I reluctantly agreed and he has been on formula for 24 hrs already and I've been pumping. She said he probably wouldn't get nipple confusion because he's ben breastfed for 4 weeks already...i was in tears last night and all today about this and praying this is all only breastmilk jaundice. I also am praying I'll be able to nurse again. I'm scared because he clearly is yellow in his eyes(although not severe He has gained 1pd 6 oz since birth and has grown 3 inch which the dct felt was a positive sign. Quote Link to comment Share on other sites More sharing options...
Ellie Posted June 7, 2011 Share Posted June 7, 2011 I don't believe there's such a thing as "breastmilk jaundice." If someone can point me to a LLL article that says that, I'll believe. The very idea of someone telling you to stop nursing for 48 hours is just silly. The cure: nurse as much as possible. If you were giving bottles of water, stop it. If you were using a pacifier, stop it. Nurse all.the.time. Take baths with the baby and see if he'll nurse while you're in the tub. Sleep with the baby all night and see if he'll nurse. Take naps during the day and see if he'll nurse. Every time you sit down, see if he'll nurse. He shouldn't go longer than an hour, hour and a half (which is more frequent than usual, but these are special circumstances). Don't stop nursing. Don't go back to that doctor. Find a new one, one who actually knows about bre*stfeeding. Quote Link to comment Share on other sites More sharing options...
J'etudie Posted June 7, 2011 Share Posted June 7, 2011 All five of mine had this. It took about 6 weeks to dissipate. Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 7, 2011 Author Share Posted June 7, 2011 I believe you I really do but i'm so scared because she called another hospital and talked with the gi specialist and this is the advice they gave so i'm just scared if its not breastmilk jaundice, then why is my 4 week old still jaundice, why are his bili s still elevated, and why did his eyes turn yellow? if its not this, i fear something worse is wrong and i'm scared... sorry for the lower case letters...i'm holding baby Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 7, 2011 Author Share Posted June 7, 2011 his total bilis are 12.7 his direct bilis are 0.3 Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 7, 2011 Author Share Posted June 7, 2011 and i get tons of comments on his pretty color too:tongue_smilie: Quote Link to comment Share on other sites More sharing options...
LittleIzumi Posted June 7, 2011 Share Posted June 7, 2011 his total bilis are 12.7 his direct bilis are 0.3 Miligrams? Because that doesn't sound very high. My baby was jaundiced & his were quite a bit higher than that & we just got the advice to BF more. From Dr. Sears: " Bilirubin levels average 2-3 milligrams higher in breastfed infants than in formula-fed infants (14.8 milligrams versus 12.4 milligrams). The difference is thought to be due to an as-yet unidentified factor in breastmilk that promotes increased intestinal absorption of bilirubin, so that it goes back into the bloodstream rather than moving on to the liver. Higher rates of jaundice in breastfed infants may also be related to lower milk intakes in the first days after birth, because of infrequent or inefficient feeding. It is normal for jaundice to last a bit longer in breastfeeding infants, sometimes until the third week after birth. While most newborn jaundice is harmless, common medical remedies for jaundice can interfere with getting breastfeeding off to a good start. Therefore, healthcare providers and parents should be cautious about treating a condition in which the cure can create more problems than the disease. Watch out for what we call the "yellow flags" that signal an overreaction to jaundice in the breastfeeding baby. In most cases, it is not necessary to treat jaundice when bilirubin levels are less than 20 milligrams." Quote Link to comment Share on other sites More sharing options...
LittleIzumi Posted June 7, 2011 Share Posted June 7, 2011 And from the AAFP "Phototherapy should be instituted when the total serum bilirubin level is at or above 15 mg per dL (257 mol per L) in infants 25 to 48 hours old, 18 mg per dL (308 mol per L) in infants 49 to 72 hours old, and 20 mg per dL (342 mol per L) in infants older than 72 hours." Ds was over 20 & still just being monitored & BFed, not worried about. Quote Link to comment Share on other sites More sharing options...
Tammy P. Posted June 8, 2011 Share Posted June 8, 2011 My oldest (who is now 12) had breast milk jaundice too. Her bilirubin counts were as high as 21. She had to stay in the hospital for an extra week right after birth to stay under the lights. The way the doctor explained it to me was that it had something to do with the Rh factor. I had to "pump and dump" my milk for two weeks and supplement with formula just until she had the nasty seedy bowel movements. Once her b.m.'s were no longer "seedy", I was able to continue breastfeeding. I nursed her until she was 8 months old. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted June 8, 2011 Share Posted June 8, 2011 I believe you I really do but i'm so scared because she called another hospital and talked with the gi specialist and this is the advice they gave so i'm just scared if its not breastmilk jaundice, then why is my 4 week old still jaundice, why are his bili s still elevated, and why did his eyes turn yellow? if its not this, i fear something worse is wrong and i'm scared... sorry for the lower case letters...i'm holding baby His eyes are yellow because that is what happens when you are jandiced. That just means he has a bit of a buildup of billirubin. The levels you quoted are not dangerous. What is called "breastmilk" jaundice is just a normal thing that happens to some babies. At the levels you are talking about there is no danger at all. They said to try formula because they are NOT educated in breastfeeding. And if your baby never breastfeeds again they don't care. They just don't have a stake in that. You do have a stake in it, and have to decide how to handle this. It is totally your decision, and you have to do what you can live with. Personally, with levels like that I wouldn't stop breastfeeding. Not when all the evidence says that there is no danger. But only you can make the decision for your family. Quote Link to comment Share on other sites More sharing options...
Ellie Posted June 8, 2011 Share Posted June 8, 2011 I believe you I really do but i'm so scared because she called another hospital and talked with the gi specialist and this is the advice they gave so i'm just scared if its not breastmilk jaundice, then why is my 4 week old still jaundice, why are his bili s still elevated, and why did his eyes turn yellow? if its not this, i fear something worse is wrong and i'm scared... sorry for the lower case letters...i'm holding baby There is no such thing as jaundice that is in any way caused by breastmilk. Your 4wo is still jaundiced because he still is. How often does he nurse? Do you supplement with *anything*? pacifier? water? anything? And have you called La Leche League? If not, you should do that right now. I'll wait while you look up the number... Quote Link to comment Share on other sites More sharing options...
mommyoftwinboys Posted June 8, 2011 Author Share Posted June 8, 2011 I'm calling LLL in the morning... I did speak with a lactation consultant and she didn't have much info to give me...:confused: Quote Link to comment Share on other sites More sharing options...
scholarly Posted June 8, 2011 Share Posted June 8, 2011 I just checked the newest edition of The Womanly Art of Breastfeeding. LLL says not to worry about breastmilk jaundice and that more breastfeeding is suggested. Formula brings down the bilirubin levels more quickly than human milk, but the long-term advantage lies with continuing to nurse. (pg 395-396) :grouphug: to you and Baby Quote Link to comment Share on other sites More sharing options...
Carrie12345 Posted June 8, 2011 Share Posted June 8, 2011 Ds was in the 12s for a little while there. His jaundice didn't completely go away until about 5 weeks, no supplements. He happened to be born in the winter and our windows are UV treated, so that didn't help, lol. He was FTT due to milk/soy protein intolerance, but we didn't find that out until a few weeks later, and the jaundice was gone by then. It's certainly possible that that did play a part in his case. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted June 8, 2011 Share Posted June 8, 2011 (edited) This is from a medscape article: Increase breastfeeding to 8-12 times per day and recheck the serum bilirubin level in 12-24 hours. The mother should be reassured about the relatively benign nature of breast milk jaundice (BMJ). This recommendation assumes that effective breastfeeding is occurring, including milk production, effective latching, and effective sucking with resultant letdown of milk. Breastfeeding can also be supported with manual or electric pumps and the pumped milk given as a supplement to the baby. and.. Temporary interruption of breastfeeding is rarely needed and is not recommended unless serum bilirubin levels reach 20 mg/dL (340 µmol/L). and finally.. The most rapid way to reduce the bilirubin level is to interrupt breastfeeding for 24 hours, feed with formula, and use phototherapy; however, in most infants, interrupting breastfeeding is not necessary or advisable. This is the link to the whole thing if you want to print it and fax it to your doctor, or email it. It really sounds like your pediatrician is very inexperienced in this if she is calling around to talk to GI doctors for something that is fairly common. I'd personally ask around for a breastfeeding friendly pediatrician (the lactation consultant would probably know) and go there for a second opinion. Also, I know the yellow eyes are scary, but the eyes turn yellow even with very mild jaundice, they are the first things to show jaundice in fact. This article mentions that even levels as low as 5 would show in the eyes. So don't let that scare you. http://emedicine.medscape.com/article/973629-overview Edited June 8, 2011 by ktgrok Quote Link to comment Share on other sites More sharing options...
ktgrok Posted June 8, 2011 Share Posted June 8, 2011 And this is a link to the CDC's article on it: http://www.cdc.gov/breastfeeding/disease/jaundice.htm This is the relevant part (note that the recommendations are from the American Academy of Pediatrics): Breast milk jaundice is far less common and occurs in about 1 in 200 babies. Here the jaundice isn't usually visible until the baby is a week old. It often reaches its peak during the second or third week. Breast milk jaundice can be caused by substances in mom's milk that decrease the infant's liver's ability to deal with bilirubin. Breast milk jaundice rarely causes any problems, whether it is treated or not. It is usually not a reason to stop nursing. In July, 2004, the American Academy of Pediatrics (AAP) published guidelines intended to reduce the onset of these more severe, yet preventable, conditions. According to AAP Subcommittee on Hyperbilirubinemia, for every newborn born at 35 or more weeks of gestation, health practitioners should promote and support successful breastfeeding: "Recommendation 1.0: Clinicians should advise mothers to nurse their infants at least 8 to 12 times per day for the first several days." "Recommendation 1.1: The AAP recommends against routine supplementation of nondehydrated breastfed infants with water or dextrose [sugar] water." Quote Link to comment Share on other sites More sharing options...
Ellie Posted June 8, 2011 Share Posted June 8, 2011 I'm calling LLL in the morning... I did speak with a lactation consultant and she didn't have much info to give me...:confused: Which is why I recommend LLL over a lactation consultant. Quote Link to comment Share on other sites More sharing options...
Acadie Posted June 8, 2011 Share Posted June 8, 2011 Both my girls had newborn jaundice and the NICU doc's advice was MORE nursing. Bilirubin is excreted in stool--the more they poop, the faster they get rid of it. And as far as I know, breastfed babies tend to poop more often than formula fed. Bililights are the treatment of choice, as far as I know, for jaundice. DD1 was in the NICU for 2 days under lights, then home with a portable bililight for another week or so. With dd2 we knew what to expect and went home with the bililight. It was covered by insurance and easy to keep her on it at home. Is there by any chance a blood incompatibility? We had ABO incompatibility. Let's see if I can remember this...I'm type O and my girls are either A or B. Somehow our blood mixed a bit and I formed antibodies to their blood cells, which caused increased breakdown of RBCs and thus more bilirubin for them to excrete. Also, it's turned out that both girls have food intolerances. This isn't uncommon in my family, so I think a number of us have very mild liver issues, meaning it takes us a bit longer to break down some substances than it does for the average person. However, we're all healthy and happy despite that! Please know that lots and lots of babies have jaundice and that there's an elevation in IQ associated with high bilirubin, as long as it's not above a certain level. Dd1's was 18 and she's as smart as a whip. Don't let this interfere with your nursing relationship. We did have some unrelated interruptions in nursing that led to mastistis for me, antibiotics, and then yeast issues for both of us. The yeast has been a long term problem. Snuggle that baby and nurse, nurse, nurse! And congrats on your new litle love. Amy Quote Link to comment Share on other sites More sharing options...
Mrs Mungo Posted June 8, 2011 Share Posted June 8, 2011 I'm calling LLL in the morning... I did speak with a lactation consultant and she didn't have much info to give me...:confused: Which is why I recommend LLL over a lactation consultant. I agree. Oftentimes, people called "lactation consultants" in hospitals are not "real" lactation consultants. What I would consider a "real" lactation consultant is one certified by the International Board of Lactation Consultants. However, those in hospitals are often nurses who have taken an extra class or two in breastfeeding. On the other hand, LLLLeaders have breastfed their own baby for at least year, have received 6-12 months of training from their mentors, and have usually done co-peer counseling with their mentors. his total bilis are 12.7 his direct bilis are 0.3 This is just not a dangerous level. I don't understand why she is so concerned. yes, baby probably needs some blood test screenings to check for other potential issues (like ABO incompatibility). But, doctors don't usually do anything about late onset jaundice (the new name for what used to be called breastmilk jaundice) unless bili levels are over 15 milligrams. Even then, they just send home a phototherapy blanket. They will usually have you come in for phototherapy treatments if bili levels are over 20. But, your baby's levels are not that high. Quote Link to comment Share on other sites More sharing options...
DB in NJ Posted June 8, 2011 Share Posted June 8, 2011 My youngest was in and out of the hospital for the first 6 weeks of his life due to the same issue (jaundice related to breastfeeding). His numbers got so high, even the doctors were scared! His eyes were yellow too -- even his tongue and the lining of his mouth (including his gums) were yellow. They had me continue nursing him, even while I stayed in the hospital with him. The only time he was out from under those lights was long enough to nurse. I beg of you to stop googling and, with all due respect, stop getting advice from non-doctors. If you trust your doctor, then listen to him/her. If you don't trust your doctor, find another one and get a 2nd opinion. But please, do not get medical advice regarding your baby from here or any other online source. Hang in there! Things will get better :) Quote Link to comment Share on other sites More sharing options...
HS Mom in NC Posted June 8, 2011 Share Posted June 8, 2011 The only person qualified to give you breastfeeding advice is an Internationally Board Certified Lactation Consultant. Peds, OBs, GPs, anyone called a "lactation consultant" that has no IBCLC certification, is unqualified. Only IBCLC consultants have the years of specialized medical training to give breastfeeding advice. LLLI phone consults are for general breastfeeding questions-this is a specialized medical question. LLLI is really for moral support. My second child was jaundiced and the ped told me to nurse more frequently. Quote Link to comment Share on other sites More sharing options...
melmichigan Posted June 8, 2011 Share Posted June 8, 2011 If you would like to take the advice of the peds and still nurse you might consider/discuss getting a Supplementary Nursing System. Medela makes a very nice one. Then every time you nurse you give addiitonal supplement, either pumped breastmilk or formula, by a small tube inserted into the babies mouth as they nurse until jaundice resolves. I struggled with jandice with my DC because I don't produce as much milk as they needed at times, they had to work to much for it. SNS allowed me "get over the hump" so to speak to resolve the jaundice and continue nursing. I would then just pump after feeding to be sure to grow my milk supply. A lactation consultant would have knowledge of the system I'm referring to, they run about $20. Otherwise, I agree with everyone else's advice, nurse more often. Quote Link to comment Share on other sites More sharing options...
Ann@thebeach Posted June 8, 2011 Share Posted June 8, 2011 You are a parent and consumer that has concerns about a diagnosis. You should call your Dr. NOW (no matter the time-that's what being on-call is for) and ask her about the diagnosis and that you have concerns. Ask her how old her information is that she is consulting. Your Dr should respect your concern and offer you more info on why they gave you that info. You could even give her the current info that you have found and ask her to comment on it. Tell him/her that you feel that nursing more may help instead of hinder (if you feel that) and what his/her thoughts are on that. Formula is digested slower than breastmilk, FYI, so it would make sense that breastmilk would help move toxins out of the system faster. I agree that you should go back to your Dr and discuss it with them. You CAN go against their diagnosis if you have enough info to feel comfortable. I have done this more than once and told my dr why. She has always agreed with or supported my alternative course of action after hearing my reasoning (I'm also a LLL Leader and it's often been about bfing/food/shots). I also do not think Drs are all-knowing and OFTEN do not have the most current or correct information about breastfeeding. Quote Link to comment Share on other sites More sharing options...
Slartibartfast Posted June 8, 2011 Share Posted June 8, 2011 (edited) my baby had jaundice with higher bili levels and the IBCLCs working with us never told us to stop breastfeeding. He was in the nicu and I would have to be in there every three hours on the dot to nurse him. *yeah I was a mess* Your Dr is gviing you bad advice. You can ask for a bili blanket but I would NOT stop nursing. I would recommend you ask for a referral to an IBCLC Edited June 8, 2011 by Sis Quote Link to comment Share on other sites More sharing options...
Dawn in OH Posted June 9, 2011 Share Posted June 9, 2011 My third child had jaundice in 2007, and the advice we were given, by multiple doctors and nurses and both the Ped's office and the hospital were to nurse as much as possible and set him in his car seat in front of a window. Quote Link to comment Share on other sites More sharing options...
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