Help fast! Premie jaundice

[SublimeBirthGirl]

I have a student who gave birth naturally to a 5 pound, 7 ounce 35-weeker 2.5 days ago. Mom is *extremely* healthy and active (still running 5 miles shortly before baby was born). Baby is fine, breathing and normal. The hospital is trying to force the mom to supplement and are refusing to release the baby. They want to do phototherapy for jaundice. Baby's bilirubin levels are 12. Even just on colostrum/breastmilk, baby had 7 bowel movements yesterday. My understanding is 12 is the high side of normal/low side of jaundice, that they watch more closely at 15-18, and usually recommend phototherapy at 20. Is this different for babies born early? They will not let the mother stay with the baby overnight, so she would have to sleep in the car in the parking lot and go in every 2 hours to feed the baby, if she refuses supplementation. They told her she can't rent the bili lights because they aren't as strong as the ones they have in the hospital. But I'm thinking at 12, frequent nursing plus sunshine should do. I'm in GA, sunshine is not in short supply. Any input?

[Reha]

I agree with you here. That hospital sucks! : : I can't believe they are pushing supplements and not letting mom sleep there. That baby needs her milk more than anything!!!

I have seen the same as what you write about bili levels and treatment in texts, but then I know that our local hospital has also treated with lights (on a full term baby) at 15, I believe. I think many hospital providers are very conservative when it comes to jaundice.

[Defenestrator]

Does she have a pediatrician? Does that pediatrician have privileges at that hospital? She might be able to get her ped to advocate for her or to take responsibility for the baby so that the hospital will back off.

I believe that they are acting on the assumption that the jaundice will get worse since it tends to peak at day 3-6. 12 is not bad at all, but a higher number could be.

If I were in her shoes and I wanted to go home badly I might put my foot down and say "I understand that a bilirubin level of x is a cause for concern for my baby. I will make sure to have daily bilirubin levels taken and consent to readmittance if I consult with my pediatrician and believe that the levels have risen above a safe level."

[channelofpeace]

My baby had to be monitored for pathological jaundice because he and i had a blood incompatibility and they still let us go home with the bililights and we took him in daily for bloodwork. Breastmilk is truly and really the best thing for a jaundiced baby since it flushes out the mec and pooing helps get rid of bilirubin. It sounds like they are feeding your client a bunch of bull.

I can't believe that people so ignorant of biology are allowed to practice medicine

[khaoskat]

I would contact an attorney who is pro natural birth/attachment parenting, and file with the court first thing in the Morning Tuesday (today is a holiday) for a Court Order to release the child to the parents. I would contact my child's Ped and get an RX for the bili-lights today, and have them ready at home.

The reason I say get a Court Order, this way they cannot call child protective services on the parents and have the child removed from their custody pending Court intervention.

Turn the tables on the hospital...use their own tactics against them.

As for not allowing mother to stay all night...does she have a partner (ie husband or significant other). She might be able to catch a few hours of down time by having her partner come and stay with the child to monitor that they don't do anything that is not wanted...and she might even been able to send in some expressed milk/colostrum to feed baby by either syringe or finger feeder.

Other than the high bili levels, nothing else is wrong with the child. I wouldn't see why a Court wouldn't release the child, with the understanding that the parents will have levels tested daily (which can be done by a home health care nurse visiting daily, or taking the child to the ped or lab daily) and allow the child to remain home with a bili blanket and natural sunlight.

[adoremybabe]

My first born's bili levels peaked at 18 when he was four days old and the doc had us using a bili blanket at home and never mentioned supplementing. We went in for daily blood work until his levels went back down. I am sorry that she is having to go through this.

[SublimeBirthGirl]

Thanks everyone! They got in touch with the ped they were planning to hire but hadn't yet. She's an LC and very NCB-friendly and is helping them out. They will NOT be supplementing, and will get to go home tomorrow instead of at least Wednesday. It's progress!

[the elyse]

i rented a bili light with my 33 weeker...worked great. she went home with me 3 days after birth. and i wasn't forced to supplement. i had a fabulous pediatrician, that might be the difference.