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Jaundice: My Hospital Experience

post #1 of 38
Thread Starter 
I am new to posting on these boards, although I've been lurking here for many years. So please forgive me if I'm not posting this is in the correct section and apologies for the manifesto. I had quite a breastfeeding battle after the birth of my first son 3 years ago, and it still bothers me to this day. If I can help even one other person by sharing my story, then it will be worth it.

Nothing went according to plan (does it ever?) with the birth of my first son, and I ended up with a c-section. But that's another story. I was adamant about breastfeeding him from the time I became pregnant and indicated as much in my birth plan. And thankfully I had a supportive DH to stick up for me when I was in pain and not as coherent as I could have been. Anyway, despite resistance from the nurses, I got my son to latch and nurse in the recovery room after my surgery. And it was amazing! After about 10 minutes the nurse actually pulled him off me to take him away for cleaning and testing

I had tested borderline for gestational diabetes and had refused to take the 3-hour test during my pregnancy. I researched and was very careful with my eating and made an educated decision not to do that. Little did I know that the hospital would consider me a "gestational diabetic" by default for not taking the test. And so they immediately pricked my infant son's heel to test his blood sugar (we should have told them no, first-time parents faced with overwhelming pressure in a technology-focused hospital). After the test, an extremely pushy nurse told DH my DS would be having a bottle of formula. DH informed her that he would not be having formula, and he really had to fight it out with her. She claimed his blood sugar was on the low side, then admitted it was 54, and that the cutoff for low sugar was actually 40, so his level was perfectly normal! First battle won. I was then moved to a post-partum room where I nursed my son regularly, and he was a great and enthusiastic nurser.

We battled the nurses during our entire four-day stay as they continually tried to give DS formula. The final and most traumatic battle happened on our last day. A nurse had noticed the day before that DS "looked a little jaundiced." My research confirmed that more than 50% of newborns experience this, especially when breastfeeding. The pediatrician checked him out and said he wanted to do a blood test to make sure his levels were OK. I accompanied him to the nursery for this one and got to see firsthand the horror of him getting pricked in the heel for the third or fourth time. I got so emotional I had to leave him and DH there (my postpartum hormones were raging by this point and I was SO ready to go home).

After the test was done, I was discharged and we began packing up the room and getting ready to leave. The doctor called and told us DS had tested at 17.5 (his bilirubin level), and that he strongly recommended DS be put under special lights for a few hours and given formula. My geeky DH had his laptop with him and we frantically began doing research on the hospital's WiFi network. We learned that we could likely handle any levels under 25 (per the La Leche League and a few other resources) without this type of intervention. I was convinced (major mother's instinct kicking in here) that all he needed was a couple of quiet days at home breastfeeding and some exposure to sunshine and he would be fine. DH told the doctor we were declining the treatment and he was unhappy, but we were firm. We compromised and decided to test him again the next day, and if the levels had gone up then we would reconsider treatment.

Sure enough, after less than 12 hours at home with us his levels had gone down. No lamps and no formula. By the time he went for his 2-week pediatrician’s visit there was no sign of jaundice, and he had gained up to his birth weight – plus an additional 7.5 ounces. The pediatrician said he was perfectly healthy and was actually surprised at how quickly he had flushed out the jaundice and gained weight without medical intervention. Duh.

I had a much better hospital experience with the birth of my 2nd DS. But I know this sort of thing must happen all the time at big hospitals and even though we weren't prepared for it, we successfully fought for our breastfeeding rights. It angers me to this day that my breastfeeding relationship with my son could have been jeopardized had I agreed to formula and artificial lamps instead of mother's milk and quiet snooze time in the sunbeams of my own home.
post #2 of 38
, Momma... Stories like yours keep me doing what I'm doing.

It's a shame that during a time where we (caregivers, family, society as a whole) should be protective of the newborn mother-baby pair we often make life harder for them. A new mother shouldn't have to waste her energy shaking off unwanted advice and fighting with medical staff but all too often, that's the sad reality.

to you for standing your ground and I wish you many more of those moments!
post #3 of 38
Good for you, OP.

I looked at the birthdates of your dc and my ds1 is only one day older than your first. Similar story - c/s, babe taken to NICU for blood sugar because I refused the GD test, fights about formula (I lost - not enough knowledge). So glad you stood up. It's somehow a small comfort (maybe the wrong word?) to connect with someone who was going through something similar at exactly the same time. We made it. Happy 3rd birthday to us and our darling children!
post #4 of 38
Yep - same here. When my first son was born, we were sent home with a bili-bed and I was told to leave him on it except for when nursing and changing diapers. I was also told to use formula, which I refused. Since we got a visit every day from the "heel prickers" I would get a call every afternoon about his bilirubin levels and I too ended up doing my own research. Turned out the bili-bed wasn't even recommended for his level and I demanded it be returned.

When our second son was born, I was prepared. Again, we got the bili-bed (which we returned the next day after learning his levels and telling the doctor that even the AAP doesn't recommend phototherapy at this level...), and the heel pricking nurse who came to the house told me that I had to quit nursing for a day and give DS formula. I told her no. Then she had the gall to say "That's the doctor's decision, not yours." To which I laughed and replied, "No, actually, that is MY decision. He is MY child."

Imagine her surprise the next day when I told her we'd no longer be needing the bili-bed! It pays to educate yourself. Really takes those high and mighty "professionals" off guard.
post #5 of 38
Quote:
Originally Posted by Anastasiya View Post
(...)
When our second son was born, I was prepared. Again, we got the bili-bed (which we returned the next day after learning his levels and telling the doctor that even the AAP doesn't recommend phototherapy at this level...), and the heel pricking nurse who came to the house told me that I had to quit nursing for a day and give DS formula. I told her no. Then she had the gall to say "That's the doctor's decision, not yours." To which I laughed and replied, "No, actually, that is MY decision. He is MY child."

Imagine her surprise the next day when I told her we'd no longer be needing the bili-bed! It pays to educate yourself. Really takes those high and mighty "professionals" off guard.
Whoa, that was rude! This makes me wonder again - how are medical staff trained to communicate to patients?
post #6 of 38
Wow, 17.5 was my daughter's level and no one suggested she be given formula or put under lights. The next day, with nursing and sun exposure, it started dropping. Thank goodness we didn't have panicky doctors...but if we had I would have fought too.

I am enraged reading these stories. "The doctor's decision, not yours?" WOW.
post #7 of 38
Different doctors really do react differently to similar situations. With my twins, one was jaundiced. We were told to watch his color, nurse lots, and keep him in sunshine if it was possible. I don't believe they retested his levels. The doctor in question was chosen because of his support of breastfeeding over a doctor we'd been warned about.

Not quite three years later, in a different state, my daughter had lower level than my son had had. Doctors were worried. We were told if it went much higher she'd need the bilibed. We were brought in for a repeat stick. The doctor even stated that up to half of babies are jaundiced without complication, but that protocol is that follow-up testing be done and intervention occur.
post #8 of 38
Totally different circumstances but basically the exact same experience here. I am STILL angry a year later about how much the dr's & nurses undermined BF'ing. I am proud of myself for standing up to them but still wish I could have been even stronger (i.e. not allowed that one ounce of formula they "forced" me to give him which he threw up... and all the heel pricks... etc.) I just can't believe that a MEDICAL ESTABLISHMENT, which should know what is best for the baby as well as the science etc. behind BF'ing, would be so anti-breastfeeding. I don't understand it. DH wants us to have a homebirth next time around so we don't have to deal with that (and other hospital problems) but I'm not sure I'm up for it.

Anyway, good for you for sticking up for yourself & your baby!!!!! I can't believe the nerve of those nurses...
post #9 of 38

blood sugar too!

Good for you!

The other newborn nursing issue that seems to come up a lot is one you mentioned, blood sugar.

Fortunately for me, it was something I was aware of and researched well before it was an issue for my family.

My first two babies were born in the UK, then I moved to the US. A friend here mentioned her baby had been in the NICU, when I asked why, it was due to low blood sugar, but found as a routine test, not due to symptoms or the GD status of the mother, she said it was because he was so big. At 11lb4oz he was big, but I remembered the baby next to us in the open plan ward in the UK was 10lb13oz and wasn't being tested for anything, so I thought maybe the cut off was between those two weights.

I ended up researching it and found that whilst larger babies are more likely to have low blood sugar, having low blood pressure without symptoms doesn't cause any long term problems, so the WHO doesn't recommend routine testing on any weight cut off, but symptom based testing.

My planned homebirth with #3 turned into a scheduled c-section at about 2 weeks notice, so I didn't have ask every question I would have done had there been more time. I hadn't done any GD testing, but I wasn't treated as if I had GD (good!).

I did express colostrum before the birth, mostly because I could and my first baby was IUGR and slow to start breastfeeding and I had to hand express colostrum for him, so at some point after him but before #2 I decided that in future I'd express some in advance and freeze it, we didn't use it with #2, but I stuck with that plan for #3 and brought it in to the hospital and they stuck it in a freezer somewhere.

Turned out she wouldn't nurse after birth, don't really know why, it didn't seem to be drowsiness, she was quite happy to be skin to skin and near my breast and awake with eye contact, but made no attempt to latch.

I was surprised how long the nurses reassured us that this was ok and didn't try and do anything, but eventually 12hrs after the birth, it was suggested we do something, which ended up being defrosting the first bag of colostrum and DH feeding it via tube and syringe and a breastpump appearing. It was all calm and I think they'd have waited half an hour for me to pump if the frozen colostrum wasn't available.

She was fed like that overnight, we decided to let her go to the nursery, it didn't seem like she'd suddenly start feeding in the middle of the night and it seemed like sleeping well might help our efforts the next day.

In this hospital, whilst there still is a nursery, it's only for about 6hrs overnight, so about 6am they began to bring her to us, but noticed she was displaying symptoms (shaking) that could be low blood sugar, so tested her, found it was low, 31, so brought her too us with the demand that she was fed instantly, which DH did, they retested and it had dropped further, 19.

So it was off to the NICU for her, she did fine, we tried to breastfeed, but didn't manage it, but she was fed only my milk, again with tube and syringe. When she was discharged we were told officially that she shouldn't be discharged, as she wasn't taking enough milk, but they didn't seem to want to keep her either, so off we went, I offered her a breast in the short time after we left the NICU, but were still in my room to get all the admin done and she took it, though it turned out that was the beginning of a 2mth struggle to get her exclusively breastfeeding, which is nothing to do with blood sugar!

We had the knowledge, but everything was handled so well, we barely needed to use it, her first feed wasn't "we need to give her a bottle of formula", but "we need to do something". We met with no resistance to our no artificial nipples stance, though it wouldn't be the course they took if we hadn't brought it up.

So we had a good experience, though I still didn't know if they routinely tested based on weight and if they did what that cut off was, until last week, when I spoke with a friend who had a baby there in September, they test all babies above 9lb! So her baby was tested in the delivery room and given a bottle of formula. The labour and delivery nurses are totally different people to the post partum nurses and obviously there still could be variation between individuals. The friend mentioned that she knew better now, but you can't possibly research everything in advance. Which is why I'm posting here, blood sugar seems to be the other common reason for a bottle of formula to be given early on.
post #10 of 38
Thread Starter 
Thanks for the support everyone. I wanted to stress that I had a completely different experience with the birth of my 2nd DS in a much smaller hospital. They were very encouraging of breastfeeding and very hands off in so many ways. I really does think it depends on the hospital and staff. My first experience was in a large and very well known hospital and I've heard what happened there is pretty much standard. At least getting this info out there can help other mammas-to-be who may have to face this kind of resistance.
post #11 of 38
Definitely agree on the blood sugar. DD2 was slightly jaundiced, but her levels were reasonable so no one gave us any hassle about that. She was, however, born at 9lbs 4.8oz and they were concerned about her blood sugar (I passed the GD test with flying colors however). Anyway, they tested her sugar right away, then said she should be tested after each of her first 3 feedings to make sure it didn't drop too much. So... I got those first 3 feedings out of the way in the first 2-3 hours :-) Didn't give it a chance to drop & after that they didn't bother me again.

Now, I'm reasonably satisfied with that outcome but still regret the repeated sticks. Next time I'll do even better & refuse that.
post #12 of 38
There is a relationship between early cord cutting (which happens with c-sections and usually with vaginal births) if you want to read up on that..

My first ds' cord was cut after a minute but still pulsating. By the next day he was VERY yellow and his level reached 22. The hospital never discouraged bfing or pushed formula.

My dd's cord wasn't cut for at least an hour and did not have any issues with jaundice.
post #13 of 38
I was impressed that our hospital had a middle ground for dealing with jaundice. The lactation consultant had me nurse, then pump, feed the baby and only then give small amounts of formula. By the time my milk came in hardly any formula was needed. After the milk we stopped the formula completely. Now, at three months we have a great nursing relationship.

I hate thinking that a mama has to make an all or nothing choice in either direction.
post #14 of 38
*HUGS* to you mama, I had a similar experience with the birth of my son. Eventually I would like to write and post my birth story and outline all the stressful things that happened. We had a home birth, and 9 hours later had to bring ds to the hospital - i wont go into all the detail here as to why - The residents notice on day 2 or 3 that DS had a bilirubin level of 13.9 and order he be put in a incubator with a biliblaket and lights. His levels peaked 10 hours later at 16.6. It was BS. I was so weak and sad and worn out after a more then 2 day labor that I mentally checked out to everything the moron interns and residents were pushing on us. The only reason IMO that DS had bilirubin levels he had was because we were stuck in a dark hospital for a week. They pricked his food so many times. I should have stood up. I should have really done more research. Its so hard in the hospital. And then a week later they were a little concerned about slow weight gain, but they caused it by interfering with our on demand BF by insisting he be in the darn incubator! As you can see I am messed up about the whole ordeal. At one point the head doctor told the inters they could only pick his foot once more, because they were doing it 2 time a say at this point. i wish i would have been the one to tell them no more.
post #15 of 38
Both of my sons had jaundice early on, but no one even tested their levels, I was just told to get them in the sunshine, I did, their jaundice disappeared in a day or two. It seems they don't freak out so much over it here.
post #16 of 38
Quote:
Originally Posted by ursaminor View Post
. i wish i would have been the one to tell them no more.
You went through so much! You did the best you could with what you had at the time. We can't be prepared & armed with research for every possible scenario. And after a difficult & exhausting labor & birth you're in no condition to fight the "professionals".... Just want to send you hugs & let you know I think you did a great job in the circumstances you were dealt!!
post #17 of 38
Why why why do doctors and nurses get to treat us like we are sub-standard? There have been times when I was made to feel like the biggest idiot on the planet for even questioning a procedure they wanted to "do" on one of my children...I very much resent it still.

A friend of mine had twins born prematurely, both with Downs Syndrome. They had to fight tooth and nail to have any rights at all when it came to "treatment" for their babies. From circumcision to vaccination, breast feeding and home treatment.....everything these parents did was second guessed, over ruled and generally discarded by the doctors who were/are considered experts in their field.. My friend told me later how depressing it was to have to literally stand guard over her babies because if she went home (a two hour drive each way) the doctors and nurses were immediately in the room doing stuff they KNEW she was going to question. She said THAT was more tiring and frustrating than her children being in ICU. Her husband is a man of very strong opinions and character so she feels very very blessed to have him as back up.

This same couple had a son who died from a rare form of inoperable brain cancer about a year earlier. You cannot even begin to imagine how they had to fight doctors who wanted to do this, that and the other thing to him. He was dying. There was not a thing they could do for this child. The doctors told them that. They wanted to take him home to die, he wanted so much be around his brothers and sisters because he just wanted to go home. My friends were threatened with the police if they tried to take him out of the hospital. They really wanted to use this child like a guinea pig. It was just awful. My friends got a lawyer so they could take their little boy home. WHY should they have had to do that? It's just so wrong on so many levels.
post #18 of 38
Thread Starter 
Momo7, that is so horrible about your friends' experience. Good for them for fighting to bring their child home.

Quote:
Originally Posted by ursaminor View Post
I was so weak and sad and worn out after a more then 2 day labor that I mentally checked out to everything the moron interns and residents were pushing on us. The only reason IMO that DS had bilirubin levels he had was because we were stuck in a dark hospital for a week.
I completely relate to what you're saying, it is just SO hard under the circumstances. And I also think my son's levels were up from being under flourescent lights for nearly 4 days. Oh and not only did they *yell* at me for cosleeping with him in my bed in the hospital, but they also *yelled* at my husband for doing the same with him on the bench near the window, which was his only exposure to natural light during his stay.

Let me add that the smaller hospital where I had DS2 didn't say a darn word to me for BFing/cosleeping with my son in my hospital bed.
post #19 of 38
My nephew didn't nurse for several hours after he was born--he was very tired, and then drowsy. The midwife said something about his blood sugar, and I sort of expected her to suggest sugar water or formula. Instead, she turned to my sister & asked if I could give him some of my milk (I was still nursing my 2-year-old). I couldn't get him to latch on, but I got some drops in his mouth. Soon afterwards, he perked up and figured out how to nurse from his mom. It was an amazing experience for all of us, and 11 months later he's still loving his numnums. I wonder how often that happens in a hospital?
post #20 of 38
My daughter was 2 weeks late and 8lbs 11oz. (I know that is bigger than average but it's not huge.) After a smooth unmedicated, vaginal birth, she latched on immediately and nursed for 40 minutes! A pediatric physician's assistant waited patiently to examine her. The PA told the nurse that she would need to have her glucose levels checked. The nurse replied incredulously, "are you sure!" I didn't realize it at the time but the nurse was clearly aware that a baby who just nursed for 40 minutes and displays no symptoms does not need her glucose levels checked. The PA cluelessly replied, "Oh yes, it's right on this chart. At this gestational age and birth weight she needs to be checked."

As I said, I wasn't educated and they did do a heel prick. Just one. The next day, I saw the LC consultant and after speaking to her I realized what that conversation had been about.

I had a pretty good experience at my hospital. I also know a mom who asked for her baby to be supplemented with donor milk when she was having trouble latching. They were happy to do so...
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