breastmilk jaundice?

[donnar]

anyone ever heard of this? my ds is 6wks old today and we have been told since he was 4 days old that he looks very slightly jaundiced, but everyone who said that (peds and nurses at the hospital where he was born, public health nurse) felt it was so minor that feeding every 2hrs would resolve it. well, 6wks later he is still a little yellow and our general practitioner sent us to have a bili level taken. in the last 2 weeks he's had 3 blood tests and the results were 126, 124 and 126 just today. he consulted on the phone with a pediatrician who said it was just breastmilk jaundice at this late onset and not to worry it would resolve.

my questions are:

1. since he has been a little yellow since birth, how do they know for sure it is breastmilk jaundice?
2. did i do something to cause this? if so can i do anything to fix it?
3. how long will it last?
4. can it cause crankiness & restlessness like regular jaundice can?
5. they say it won't cause brain damage like the regular one can, is this for real?
6. how common is this?

anyone know about this? thanks for any thoughts!

[copykitten]

My dd was said to have this. I think some of the differences were it was slow to progress and slow to get better. My dd did not suffer long term from it and there was nothing wrong with me or my milk that caused it. I believe she was 2 months old before her doctor deemed her all better.

My lactation consultant gave me an article on it. I will look in my folder and get back to you with what i find. I wish it were a digital copy, but I will find something for you.

[WindsorON_Mom]

far as I know

there is no such thing!!

It's just a silly term used by peds and doctors when they can't figure out why jaundice hasn't gone away in the first couple weeks

It has nothing to do with your breastmilk.

Set your baby's playpen or crib in a spot that is recieving some sunlight. (in this heat I wouldn't say right near a window) Sunlight is a good defense against jaundice, it provides the natural vitamin D babies need.

[3daughters]

My middle dd was slightly jaundiced for about 6 weeks. No one was concerned it just went away on its own. She nursed well and gained well, she was just yellow tinged for the first few weeks of life .

From Dr. Jack Newman's handouts:

So called breastmilk jaundice
There is a condition commonly called breastmilk jaundice. No one knows what the cause of breastmilk jaundice is. In order to make this diagnosis, the baby should be at least a week old, though interestingly, many of the babies with breastmilk jaundice also have had exaggerated physiologic jaundice. The baby should be gaining well, with breastfeeding alone, having lots of bowel movements, passing plentiful, clear urine and be generally well (handout #4 Is My Baby Getting Enough Milk?). In such a setting, the baby has what some call breastmilk jaundice, though, on occasion, infections of the urine or an under functioning of the baby's thyroid gland, as well as a few other even rarer illnesses may cause the same picture. Breastmilk jaundice peaks at 10-21 days, but may last for two or three months. Breastmilk jaundice is normal. Rarely, if ever, does breastfeeding need to be discontinued even for a short time. Only very occasionally is any treatment, such as phototherapy, necessary. There is not one bit of evidence that this jaundice causes any problem at all for the baby. Breastfeeding should not be discontinued "in order to make a diagnosis". If the baby is truly doing well on breast only, there is no reason, none, to stop breastfeeding or supplement with a lactation aid, for that matter. The notion that there is something wrong with the baby being jaundiced comes from the assumption that the formula feeding baby is the standard by which we should determine how the breastfed baby should be. This manner of thinking, almost universal amongst health professionals, truly turns logic upside down. Thus, the formula feeding baby is rarely jaundiced after the first week of life, and when he is, there is usually something wrong. Therefore, the baby with so called breastmilk jaundice is a concern and "something must be done". However, in our experience, most exclusively breastfed babies who are perfectly healthy and gaining weight well are still jaundiced at five to six weeks of life and even later. The question, in fact, should be whether or not it is normal not to be jaundiced and is this absence of jaundice something we should worry about? Do not stop breastfeeding for “breastmilk” jaundice.

[JayGee]

My baby had this as well. Her bili levels normalized at 8 weeks. As long as your baby is gaining well and nursing well, there is no need to worry. I just put my DD in her bouncy seat in a sunny window 2x a day for 15 minutes and nursed, nursed, nursed.

[quirkylayne]

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[donnar]

thanks everyone! i really appreciate the info....... i feel better now, and this little guy eats all day, gaining gaining gaining! i especially loved the bit from Dr. Jack Newman:

The question, in fact, should be whether or not it is normal not to be jaundiced and is this absence of jaundice something we should worry about?

THANKS GALS! I knew I'd find help here

[3daughters]

[Momtwice]

I was told to nurse very, very often. More than two hours is also normal if your baby wants it!

[Benji'sMom]

my questions are:

since he has been a little yellow since birth, how do they know for sure it is breastmilk jaundice?

They know he has jaundice from billi levels. There is no such thing as "breastmilk jaundice", meaning that breastmilk doesn't *cause* jaundice. That term can be used to signify the fact that jaundice can last longer in BF babies than FF babies but it should NOT be used to imply that your milk has *caused* jaundice.

did i do something to cause this? if so can i do anything to fix it?
how long will it last?

No you did nothing to cause it. Please read this: http://www.kellymom.com/newman/07jaundice.html

can it cause crankiness & restlessness like regular jaundice can?
they say it won't cause brain damage like the regular one can, is this for real?
how common is this?

"Breastmilk jaundice" is "regualr jaundice", but not all jaundice is dangerous. The article I linked to has more info. Your doctor should have explained this better. I'm sorry if they said anything to you to make you think that you breastfeeding your child has made him ill, because that's just not true. (((hugs)))

[GatorNNP]

if the levels aren't too high then it is probably not from any of the pathologic causes, such as G6PD deficiency. Jaundice just means the yellow skin, breastmilk Jaundice describes a normal variant of the maturation of the neonatal liver to process bilirubin. Formula feeding infants don't have this type jaundice for several reasons, absorption by the gut is better in breastfed infants, and they resorb the bilirubin, some ethnic groups have higher bili levels initially due to normal enzyme variances, and some breastmilk will decrease the breakdown of bilirubin, but only slightly like one point different, if you do a full lit review of old and current info.
the good news is bilirubin, while irritating to the brain, does not usually cross the blood brain barrier in healthy infants who have been shown to withstand very high levels of bilirubin with no ill effects, nearly all of the recent cases of kernicterous there were other factors involved such as a compromised or sick baby. Also bilirubin is an antioxidant, and bacteriostatic so helps baby keep their blood clean. The annoying thing is not much goes well with yellow.

[~Megan~]

I think every baby has jaundice. I've never heard of a baby not having it to some degree after birth. And the breastmilk jaundice thing bothers me. Human babies were meant to be breastfed and to blame an illness on it seems asinine.

I think there are some things that can help prevent it, such as delayed cord cutting. But for now nurse often and give him plenty of time in the sun, especially in just a diaper indoors by a window.

[maxmama]

I don't know if it's a difference of perspective, but I consider "breastmilk jaundice" to be normal jaundice, while my son's pathologic jaundice was not and needed treatment. Does that make sense? I don't read it as blaming BF for the jaundice, but normalizing the experience of jaundice in newborns.

[Tori Gollihugh]

Originally Posted by donnar

my questions are:

1. since he has been a little yellow since birth, how do they know for sure it is breastmilk jaundice?
2. did i do something to cause this? if so can i do anything to fix it?
3. how long will it last?
4. can it cause crankiness & restlessness like regular jaundice can?
5. they say it won't cause brain damage like the regular one can, is this for real?
6. how common is this?

anyone know about this? thanks for any thoughts!

They don't know for sure it's Breastmilk jaundice. Did you know Physician means teacher? Well, as with most teachers, they are learning as they go, too!

My midwife believes that this kind of jaundice is caused by too early cutting of the umbilical cord. (Too early by her measure is before it has collapsed and slightly hardened.) This makes sense to me since after my DD was born I didn't cut the cord until it stopped pulsing. However, when I DID cut it, there was still blood in there and I wondered about that. DD did have slightly yellowy skin for a while, but no one ever called it BMjaundice that I remember. I know it didn't last 6 weeks, though, because I held her skin to skin under a window with indirect light a LOT in the first few weeks and she was quite pretty colored by 6 weeks.

Did you cause it? Well, beyond cutting the cord "early" if my midwife is right - probably NOT! It's just one of those things that is sort of expected because of our current birthing practices.

As PPers suggested, it'll probably last until around 6/7 weeks.

I would think (no research on this to back me, though) that any kind of jaundice can effect the way the baby feels... so sure, crankiness and restlessness may be behavioral signs.

I believe, if I remember correctly, that brain damage is only an effect of the most serious jaunice levels... NOT a slightly off color baby!

It seems QUITE common!!! Most babies I meet and see (and I see lots cause my church group has around 6-10 ladies preggie at any given time) are slightly yellow - and these are all ladies that nurse until their kiddos are 6 months old, as a rule.

[donnar]

Thanks everyone, you've all been so helpful!

Tori, I thought it was interesting what you said about the word physician meaning teacher, and that they are learning as they go. My husband always tells me "they call it 'practicing medicine' for a reason", another way of saying they are learning as they go. lol.

[GooeyRN]

I don't know much about the topic but I don't think that breastmilk is the cause. My dd only had breastmilk and she was a bit jaundiced for the first 10 weeks or so. She was very jaundiced around days 3-9 but also had a cephalohematoma from delivery. She was ultra cranky (I would be if my head looked like that, too) but now seems to be just fine at almost 10 months. I hope that your babies jaundice clears up for them.