What would you say ........ - Page 2

[julie128]

Originally Posted by readytobedone

so why do you think the formula worked to get rid of the jaundice, but breastfeeding did not? i'm not being snarky, btw. honestly curious, wanting to learn

It's the volume of the food, not the food itself that gets the bilirubin out. If the mother is not bf enough, for whatever reason, her milk can't do anything to get the bilirubin out. BM by bottle is better than formula, and getting the baby to nurse more (and exposing the baby to sunlight through a window or a bili-light in winter or a dark hospital room) is the best. Incidentally, water does nothing for jaundice.

[beccalou79]

Originally Posted by julie128

It's the volume of the food, not the food itself that gets the bilirubin out. If the mother is not bf enough, for whatever reason, her milk can't do anything to get the bilirubin out. BM by bottle is better than formula, and getting the baby to nurse more (and exposing the baby to sunlight through a window or a bili-light in winter or a dark hospital room) is the best. Incidentally, water does nothing for jaundice.

Exactly. I wish I had been able to do that right away (providing breastmilk by bottle), rather than give that formula for 24 hours, but at that point my supply was very weak. It had been two weeks and there had been little demand for it (my milk), given her lethargy from the jaundice. I did start pumping maniacally right away after that, though, and managed to give her expressed breast milk for the first six or seven months of her life, but then my supply was gone for good.

(I'm happy to report that I've very successfully breastfed her little sister for over a year now, and have been able to give my firstborn bottles of expressed milk again... it's a wonderful gift for me, to be able to do that, and incredibly healing, too.)

[HerthElde]

Originally Posted by julie128

It's the volume of the food, not the food itself that gets the bilirubin out. If the mother is not bf enough, for whatever reason, her milk can't do anything to get the bilirubin out. BM by bottle is better than formula, and getting the baby to nurse more (and exposing the baby to sunlight through a window or a bili-light in winter or a dark hospital room) is the best. Incidentally, water does nothing for jaundice.

Interesting. I've only just heard of "breastmilk jaundice" in the past month or so - on a local board there were a couple moms who were saying that they were told to switch to formula for 48 hours when their babies were little . . . I've been meaning to explore the topic a bit further, but haven't yet had the time (or any personal reasons to do so).

[thefragile7393]

Originally Posted by Jennifer-Juniper

I don't agree with the other statements about "getting nutrients" and constipation, but I take jaundice very seriously. It can be common, but that doesn't mean it isn't dangerous.

Truthfully though, there are varying degrees of jaundice and the med. profession generally treats them all the same. Mild jaundice is generally not dangerous. I saw this very example with my SIL, who nearly lost her bf'ing relationship with her child because the doc's recommendations for mild jaundice...this from a child born in a normal full-term birth.

[GoBecGo]

There are several kinds of jaundice.

Inherent jaundice (which can be from a variety of medical or genetic problems) occurs within hours of birth and becomes severe quickly. It is unrelated to what the baby is eating and needs urgent medical attention.

Normal newborn jaundice affects more or less every newborn to some degree and is caused by the bilirubin building in the baby's system as the liver has to catch up to flush them out. Breastfeeding HELPS to rid the baby of this kind of jaundice because colostrum is a laxative and gets the meconium out of the system and the digestive tract moving. Bilirubin is usually excreted in bile, so the more the baby digests, the faster they recover. Breastfeeding frequently and in sunlight (preferably skin to skin with baby in only a nappy) will resolve most cases. Even BFing near a window will do (for the winter babies).

Breastmilk jaundice affects around 2% of newborns, occurs AFTER the 7th day since birth and is caused by an enzyme in breastmilk (glucuronidase if anyone is interested) which interferes with the normal elimination process of bilirubin in the infant's liver. If the mother continues to feed the jaundice will continue and resolves eventually over a period of 1-3 months. During that time the baby will be ill, lethargic, gain weight slowly and have little interest in eating and generally do poorly until the levels have fallen sufficiently for them to recover. If the mum pumps and dumps for 24-48 hours and the baby has formula for this period the bilirubin levels fall immediately and dramatically and normal nursing can continue thereafter.

The danger with jaundice is brain damage, but this is a VERY rare outcome in both normal newborn and breastmilk jaundice. Far more common is a baby who does not thrive, becomes too thin, and ends up behind in their development simply because of the weeks (in BM jaundice) of illness. They usually do not suffer life-long effects.

In the circumstance described i would encourage mum to BF as much as baby wanted to, and let her know that her breastmilk was GOOD GOOD GOOD for her baby. In regular jaundice NO formula is necessary and in breastmilk jaundice ONLY 24 or at MOST 48 hours of formula is needed. I would let her know that 6-8 wet nappies a day meant baby was getting PLENTY of milk and that many breastfed babies go a day or even 3 between bowel movements and that constipation is only a major concern in formula fed babies.

I would offer her support of her desire to feed her baby in a way which her (so-called) care providers didn't, and i would hope for the best for her and her babe

Ultimately i would try not to be angry. Breastfeeding is the best thing for babies, but formula is very very far from the worst.

[nevaehsmommy]

So as for my daughters case where the doctors had me giving formula in the SNS to rid the jaudiace .


My daughter had a level of 8.3 when we were discharged from the hospital 2 1/2 days (my choice) after a horrible induction, reaction to epidural, c-section.

the next day it was 15, slowly climbed to 19.8 the last time it was checked. She was under the bili lights for 3 days at home. By the time her levels were under 10 she was one month old.

So my question then is, what is the casue?

Also she was very sleepy with poor weight gain, really no weight gain for almost a month.

[Code Name Mama]

Originally Posted by Ruthla

If the baby was much older, I'd commiserate that they had so little BF support in the hospital and I'm sorry they didn't get the support and information they needed to BF sucessfully.

For a 5 day old, I'd tell her to nurse, nurse, nurse, and not worry about time limits or feeding schedules- the baby's frequent nursing will help build up a good supply. I'd encourage her to talk to an LC or LLL leader for help in determining that the baby is getting enough milk, has a good latch, etc. She may need to gradually wean off supplements if she's been FF for 5 days- her milk may not be fully in yet due to the lack of breast stimulation, and she's likely to need lots of support getting BF started after that rough patch.

I woudln't feel safe telling her to keep on using formula indiscriminently because that can mess up the development of her milk supply, but I also wouldn't feel safe telling her to ditch the formula and only nurse without the baby being evaluated, because she has a 5 day old baby and possibly a supply that's better suited to a 2 day old. Combined with the jaundice, the baby MIGHT need a little bit of extra calories while her milk supply catches up.

The point is that this baby is under a week old, and with the right info and support this mom can fully BF this particular baby (assuming her hormone levels are normal, baby has normal mouth development, etc.) Forget the anger and focus on concrete help to get her nursing, and if supplements are needed make sure they're only using the amount the baby needs and only for as long as absolutely necessary.

:
I'd offer that new mama a lot of support and info, chances are she had some uninformed doctors scaring her with bad info. It happened to me, and I was lucky to have a supportive LC. I refused to give my son formula, but my decision was not supported by the NICU doctor, and I cried for days wondering if I was making a terrible mistake b/c of what the doctor told me.

Originally Posted by mommyofmany

Lack of basic knowledge about breastfeeding is really sad, and makes me angry too. You'd think some moms-to-be would actually read a book on breastfeeding if they were planning on nursing in the first place.

This response frustrates me. It frustrates me when MDC mamas look down their noses at first time mamas and judge them for not being prepared for every single contingency. How in the world can you know everything before it happens? Something you or I may think is a basic fact about parenting may be foreign to some mothers. Lord knows we don't all have perfect role models to learn from. And in the wee hours of night in the NICU, with no support from your family or friends and a doctor telling you you're making bad decisions for your days old child, it's easy to forget facts from the dozens of books/articles you've read in the preceding 9 months.
If we all knew everything, why would we come to MDC at all? I am so thankful that I found MDC in my third trimester, I continue to grow and learn every day from the collective wisdom I find here.

[nevaehsmommy]

I agree with the last poster. I was homeless the ENTIRE time I was pregnant. I was more concerened with gaining weight and finding a place to sleep at night then on reading breastfeeding books.


I read nothing on c-section because I was not going to have one ( I did) I read nothing on epidural s because I was strong ( got one!) did not read on low birth weight (trusted god to keep child healthy) did not read up on vax's ( doctor knows best) etc etc etc.

I knew I wanted to breastfeed. Told everyone I was going to breastfeed. Read articles in mainstream mags that sugar coat everything.I thought I knew everything I needed to know. But that does nothing for real life.

Real life is going two weeks past your due date. Bleeding that wont stop. Failed induction. Epidural for the pain. Crashing and dying during delivery. Waking up in the middle of a c-section. Not seeing baby for 4 hours after birth. DFS trying to yank baby in hospital. Jaudinace. Low weight gain. Low supply. Cancer. You name it. Tell me how I was spoosed to prepare for that.

We are women, we should encourage one another. Not judge. You hear of a women who was not able to nurse last child and she is pregnant and about ready to pop and want to try again. Offer your services even if you have to give up a little bit. I will be FOREVER grateful to the family that let me stay with them.

[MeepyCat]

Originally Posted by dionnakay

:
This response frustrates me. It frustrates me when MDC mamas look down their noses at first time mamas and judge them for not being prepared for every single contingency. How in the world can you know everything before it happens? Something you or I may think is a basic fact about parenting may be foreign to some mothers. Lord knows we don't all have perfect role models to learn from. And in the wee hours of night in the NICU, with no support from your family or friends and a doctor telling you you're making bad decisions for your days old child, it's easy to forget facts from the dozens of books/articles you've read in the preceding 9 months.
If we all knew everything, why would we come to MDC at all? I am so thankful that I found MDC in my third trimester, I continue to grow and learn every day from the collective wisdom I find here.

I agree with this too.

I also have to point out: I did read up on breastfeeding, and cannot now recall that my reading contained ANY reference to jaundice. Lots of talk about the importance to the infant, benefits to the mother, how to latch, how often to feed... no jaundice. Maybe it was in a chapter I didn't get to. Maybe I forgot. Maybe I filed it in my head with the other information I didn't expect to need (in a mental drawer labelled "stuff that won't happen to me", along with "vacuum delivery", and "labial tearing"). I did my research.

And if I had remembered, what then? The hospital's LC was in my room for fifteen minutes, and in that time, contradicted herself at least a dozen times. She contradicted my research at least as often. Even without the horrible LC, it might not have gone so well: I also lost all grip on metaphor during my labor and did not recover it for several weeks. Something (fortunately, something temporary) happened in my brain and I believed that people meant everything they said in the literal sense. It made ordinary conversation incredibly confusing and reading nearly impossible. We don't necessarily recover from labor instantaneously, and not all of its effects are physical.

[GoBecGo]

Originally Posted by nevaehsmommy

So as for my daughters case where the doctors had me giving formula in the SNS to rid the jaudiace .


My daughter had a level of 8.3 when we were discharged from the hospital 2 1/2 days (my choice) after a horrible induction, reaction to epidural, c-section.

the next day it was 15, slowly climbed to 19.8 the last time it was checked. She was under the bili lights for 3 days at home. By the time her levels were under 10 she was one month old.

So my question then is, what is the casue?

Also she was very sleepy with poor weight gain, really no weight gain for almost a month.

I would imagine that hers was normal newborn jaundice, complicated by traumatic (for you both!) birth, but there may have been breastmilk janudice in there too, it's hard to know. Breastmilk jaundice is easiest to diagnose when birth has been untraumatic because with normal birth the babies systems all come "online" at the normal moment, whereas with a section it can take babies bodies a while to realise they are born and begin functioning well.

When bilirubin levels go on climbing DESPITE frequent feeding and light therapy they tend to diagnose as breastmilk jaundice, but it can happen that a traumatic birth (particularly one with bruising - did they use forceps during the section? They often do!) can exacerbate normal newborn jaundice to the point they can't tell the difference.

Ultimately any serious jaundice, as you saw in your LO, causes lethargy and poor weight gain and is thus dangerous to the baby's health. Feeding a higher vbolume of food, usually formula in case it IS BW jaundice usually addresses the problem fast and without complication.

What causes problems is that healthcare professionals DO NOT explain the mechanisms for jaundice or how bile clears it and new mothers are often left feeling either that there is milk is inherently "bad" and can NEVER be given to the baby, or that they weren't giving baby enough milk to thrive (because they see the doctor push formula and the baby looking thin and lethargic). If doctors said "Formula contains none of this enzyme and bottled milk is less work for a tired baby, so we're going to give her 24 hours of bottled formula so she can get the energy up to get the good stuff from you. Here's a pump, keep your supply up by pumping every 3 hours and if you have more questions just ask." then a lot more women would probably continue to feed.