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How NOT to deal with jaundice

post #1 of 2
Thread Starter 

We just went through jaundice treatment a few weeks ago and I thought I'd share our story in case anyone else searches for help down the road!  To sum up what we learned... the treatment can mess up your breastfeeding schedule, so make sure to breastfeed for long sessions, that's 20 minutes on one breast at a feeding.  Here's the story:

 

At day 5 our preemie (born at 36 weeks) went back to the hospital for jaundice treatment... he had a bilirubin level of 21.5.  We started phototherapy, i.e. bililights.  The doctor stressed the importance of breastfeeding to flush out the bilirubin, but the bilirubin and the lights make babies sleepy and ds fussed more because he didn't want to be laying out of my arms under the lights.  Result: I fed ds more often, either when he fussed or when I woke him at least every 2 hours. A few hours later ds started having green poops (before returning to the hospital he had gotten all the meconium out and was having normal yellow breastfed poops).  The hospital doctor said that just meant that being in the hospital had altered our breastfeeding schedule a bit, no worries.  We go home.

 

The next day, the bililevels are back up and he has not gained any weight in 2 days.  I talk to the Lactation Consultant at my pediatrician's office.  She says the green poops mean ds is only getting foremilk and not hindmilk.  When we had started feeding more often in the hospital, ds was sleepy so he fed more often but for less time at each feeding.  She said when newborns feed, it takes 5-8 minutes to get the foremilk out of one breast and the milk they get after that from that breast is the hindmilk.  This is important because the HINDMILK IS WHAT FLUSHES THE BILIRUBIN OUT and also what makes babies grow and gain weight.  The foremilk is more watery and only satisfies thirst.  So she told me to feed often (at least every 2-3 hours) and do everything I could to keep ds awake and sucking for 20 minutes on one breast at each feeding.  This got us back to yellow poop, gaining weight, and lower bili levels within a day or two.  Thank goodness for the Lactation Consultant... otherwise we might have been looking at weight loss or failure to thrive and more serious jaundice treatments. 

 

It would have been nice if the doctors/nurses at the hospital had explained this to me instead of messing up our breastfeeding schedule.  And to top it off, ds got a staph infection at the hospital... thankfully it wasn't mrsa.

 

I'm cross-posting in the preemie forum...

post #2 of 2

I'm sorry to hear you went through this!  My son had jaundice after our home birth but we determined that it was the physiological kind that occurs in about 50% of babies and began clearing by day 4 or 5, so we decided not to treat.  I was really worried for a couple days there, though, trying to decide what we were going to do. 

 

Another thing you can do to address the hindmilk/foremilk imbalance (we had it with baby #3) is to block feed.  As in, you only nurse on one side for 2-3 feedings in a row, then switch.  That helps assure the fatty hindmilk is getting into baby before switching to the thinner foremilk of the other side.  This method works best if you have an oversupply/large supply though. 

I'm glad to hear things are improving!
 

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