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Discussion Starter · #1 ·
We had our second baby at home with a midwife, and it was very reassuring to have her tell me that our baby's jaundice wasn't the serious kind, and that it would go away on its own.<br><br>
This time around, we're strongly leaning toward UP/UC -- but I was just wondering if anyone knows the basic ways that you can distinguish between the jaundice that's dangerous, and the jaundice that will resolve on its own.<br><br>
I thought it would be good to hear from other UCers who have dealt with this.<br><br>
My first dd didn't have any jaundice, and I think the only reason my second dd did was that I took really high doses of Vitamin C late in pregnancy, due to a horrid, debilitating case of the flu. So maybe I can avoid jaundice entirely if I can avoid taking all that Vitamin C again. But I still thought it'd be a good idea to look into it.
 

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Newborn jaundice is most often just a variation of normal when it appears after 24hrs of birth, it is the baby's way of getting rid of excess red blood cells. The baby-placenta-cord unit has more blood in it altogether than the baby needs once it's born (to keep up the right pressure in the system for adequate blood/nutrient flow). At the time of clamping/cutting the cord, some babies simply end up with more of that blood inside their bodies than they need--so they automatically kill off the excess red blood cells. The yellow is bilirubin, a byproduct of red blood cell breakdown, which partly exits through the skin. It is actually a sign of healthy function for the baby to be able to adjust its blood this way--and only rarely does there get to be so much bilirubin backed up in baby's system that it poses a danger to baby.<br><br>
As long as your baby is nursing well and all other signs are good, you needn't worry. A baby with too much bilirubin becomes very lethargic and you will have a hard time waking baby to feed. Now, some babies do sleep a lot in the first 24-48hrs, but if jaundice were the cause of lethargy it probably wouldn't occur until after that period of 'sleeping off the birth' had passed. Normal jaundice isn't even visible until at least 24hrs. Another sign would be seeing yellow that not only was visible in eyes/face/chest, but was manifesting below the navel. Babies can get pretty yellow without it being a problem--as long as lethargy doesn't set in, and the yellow stays in the upper half of babies body.<br><br>
I'm curious tho--what makes you say that Vit C had anything to do with your other baby's jaundice? I've never seen a reference to this, and would be glad to learn something new if you have a source of that info to share.
 

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Hi-<br>
I had 3 natural births with midwives at hospitals, and none of those babies were jaundiced. I have had 3 homebirths, and all 3 had jaundice. I believe it is because of delayed cord clamping. With my last, I didn't wait as long to cut the cord and his jaundice didn't last very long. I would only worry if the child was failing to thrive (not nursing or waking much). My second homebirth baby was really yellow and I woke him every two hours to nurse, kept him in the sun as much as possible, drank dandelion root tea and it cleared up. I drank lots of vitamin C to help get rid of GBS. It helped with the GBS, but not the jaundice.<br>
HTH<br>
Rebecca
 

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Discussion Starter · #4 ·
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<div>Originally Posted by <strong>MsBlack</strong> <a href="/community/forum/post/10772661"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">As long as your baby is nursing well and all other signs are good, you needn't worry.</div>
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That's good to know!<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I'm curious tho--what makes you say that Vit C had anything to do with your other baby's jaundice? I've never seen a reference to this, and would be glad to learn something new if you have a source of that info to share.</td>
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I can't remember where I read it (sometime after the birth) -- but I hadn't been aware of it while taking the Vitamin C, and my midwife had actually said it was fine to take the Vitamin C. So I'm thinking that it couldn't cause serious jaundice at any rate.
 

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Discussion Starter · #5 ·
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<div>Originally Posted by <strong>Relynn</strong> <a href="/community/forum/post/10772973"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I believe it is because of delayed cord clamping.</div>
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That makes total sense!
 

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<div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I believe it is because of delayed cord clamping.</td>
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That is true. The odd thing is that my homebirth baby (#4) was the only baby who didn't have jaundice, and the only baby for whom cord clamping was delayed. Weird.
 

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Discussion Starter · #7 ·
Of course, since delayed cord-clamping is by far the healthier choice -- It sounds like any jaundice resulting from it will be easily resolved by the baby.<br><br>
My birth plan with my first stated that I wanted to keep the cord intact 'til it stopped pulsing -- but when they noticed meconium in my amniotic fluid, they said it would be crucial for them to cut it immediately, so that they could take Baby to their special exam table (in the same room), suction her out, and do the apgar right away.<br><br>
When I shared this with my midwife while pregnant with my second, she said it was true that meconium was serious and needed to be dealt with right away -- but there was no reason why the suctioning couldn't have been done with her on my belly. And, she added, if there's any question of airway-obstruction -- doesn't it make more sense to leave the cord intact so Baby can keep getting oxygen from Mommy while her own airways are being cleared?<br><br>
So I'll gladly keep the cord intact, at least 'til it stops pulsing! And I keep looking into lotus-birth, but dh worries that our dog would smell the placenta and try to eat it.<br><br>
Still, given the added possibility of jaundice, I suppose it's better that they cut it right away with my hospital birth. From what I've heard, medical people tend to treat <b>all</b> jaundice as life-threatening (I guess they lack the basic skill of distinguishing between the two kinds) -- and sometimes won't even let the baby nurse from the mother, which makes absolutely no sense to me.
 

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Both My DS's were jaundiced. DS1 was born in the hospital with his cord cut quickly after birth. He ended up lethargic and it took longer for his jaundice to clear. DS 2 was born at home with delayed cord clamping and his jaundice cleared up quickly and didn't get as bad as DS 1's. They both nursed well except DS 1 was hard to wake up to eat. We had to try cool cloths and undressing him to keep him awake long enough to eat. DS 2 never had that problem.
 

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Discussion Starter · #9 ·
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<div>Originally Posted by <strong>MyBoysBlue</strong> <a href="/community/forum/post/10778279"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Both My DS's were jaundiced. DS1 was born in the hospital with his cord cut quickly after birth. He ended up lethargic and it took longer for his jaundice to clear. DS 2 was born at home with delayed cord clamping and his jaundice cleared up quickly and didn't get as bad as DS 1's. They both nursed well except DS 1 was hard to wake up to eat. We had to try cool cloths and undressing him to keep him awake long enough to eat. DS 2 never had that problem.</div>
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That's a definite case for keeping the cord intact longer! Thanks for sharing!
 

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DD had very mild jaundice that started nearly a week after she was born at home. I had no chosen care provider for her yet. I was so scared I would have to take her to a hospital! I nursed her as much as possible, took her outside a lot, and watched her color. She never got lethargic and never slept too long, so she was fine. Her color went normal within 2 days.<br><br>
I watched for it from the start because I was jaundiced at around the same time when I was a newborn, and was put in NICU, which basically destroyed the breastfeeding relationship. (My mom admits she didn't try very hard, though. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad">)
 

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Discussion Starter · #11 ·
Laura, I'm glad things went well for you and your dd!
 

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I have heard from another thread around here somewhere, that the difference between the "normal" and the "bad" jaundice is whether or not the baby was born with it.<br><br>
If a baby is born and already had the "yellowing" then it is "bad" and you would need to seek help.<br><br>
If the baby developes it then it is the "normal" and will go away.<br><br>
To "treat" it yourself is quite easy. Sunlight. Sunlight will kill off the billiruben much like the lights the hospitals use. And Sunlight is free and easy to access.<br><br>
As for the delayed cord being the reason for jaundice, I have heard that over and over, but found, for me at least, it is not true. Out of my children the only jaundice we encounted was from the early cord clamped baby. All my others were late and we waited for the cord to empty, then they had no jaundice and no problems.
 

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<div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>mammal_mama</strong> <a href="/community/forum/post/10777862"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">From what I've heard, medical people tend to treat <b>all</b> jaundice as life-threatening (I guess they lack the basic skill of distinguishing between the two kinds)</div>
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i think that's probably true in a lot of cases. my son had jaundice and wasn't suffering from sleepiness or anything and they had us get a biliblanket to use at home for several hours a day. the biliblanket did cause my son to be sleepy though and it took more effort to get him to nurse well during that time.
 

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Of my 6 babies, only 2 had fast cord clamping/cutting. 1 of those had mild jaundice. None of the others had any jaundice at all. In my practice, delayed cord clamping is the general rule--never sooner than 10 min after birth, usually longer. I see very little jaundice in those babies...I seem to remember in my earliest days of reading midwifery books that up to 2/3 of newborns get some jaundice--? Hmm, or maybe only 1/3--in any event, I don't see it as often as 1/3 of babies. Maybe 1/5th of my clients babies get jaundice, tho I can't say I've ever done a statistical analysis.
 

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My dd was a month or so old before we realized she had elevated levels of bilirubin. The "ped" we had at the time didn't know what to do because she wasn't really a ped - she was more the family doc. She sent us over to the children's hospital to have tests (blood draw and liver u/s). UGH! Such a scary time for me - I thought she was okay but the doctors were making me doubt myself. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> I wondered if I was going to lose her and began to think I should detach myself from her. The "ped" mentioned that there could be a problem with her liver!<br><br>
As it turned out, she was fine - just had late-onset breastfeeding jaundice and we should continue to bf. They (the children's hospital) wanted to continue to monitor her bilirubin levels but I decided not to go back. Holding her arm for the blood draw was torture! In photos I can see that she had yellow skin and was breaking out, but in that case I just had a terrible "ped." Her bilirubin levels were under 10 and went down between the two tests, but the "ped" had never seen it in a 4-6 week old.<br><br>
She had delayed clamping and was bf the entire time - no bottles/formula. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shrug.gif" style="border:0px solid;" title="shrug">: She was born in the middle of winter, but we got some sunlight and I can distinctly recall putting her in the sunlight through the window at 10 days old to ward off jaundice. I don't recall her ever being lethargic, but I can see in the photos that she was breaking out and was yellow.
 

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Discussion Starter · #16 ·
luckymamato2 -- it's great to hear your story! I'm glad it all went well.<br><br>
It sounds like that's the case with most newborn jaundice -- that it will usually resolve just fine with breastfeeding and sunlight.<br><br>
I don't want to downplay the importance of treating the deadly kind -- I just think it makes sense to learn as much as I can about how to tell one from the other, so I'm not rushing off to the ER and subjecting my baby to a lot of unwanted interventions that aren't even necessary.
 

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<a href="http://www.drjaygordon.com/development/pediatricks/bilirubin.asp" target="_blank">physiological jaundice might be a good thing</a>
 

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Very interesting article. Makes sense. And if billiruben is more common in breastfed babies, then I have to agree that it would be natural and healthy. Doctors have tried to medicalize everything, but many actions of our bodies were put there for a reason and a purpose. It is nice to know this too may be there for a reason and a purpose.
 

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Both of my babies had severe jaundice. At 3 days of life their billi numbers were both over 20. They were yellow almost to their knees. Jaundice is not always "normal" or "healthy." It depends on the billi level and the day of life.<br><br>
One way to tell if the jaundice should be seen by a Dr is how low on the body the yellow color goes. If it's at about chest or armpit height (after 24 hours old) then it's probably not going to be a problem. However, if it goes below the waist I would take the baby in. To test this, just gently push your finger into the newborn's skin, and see what color it is before the capillaries fill it in again.<br><br>
The real risk of severe jaundice is kernicterus <a href="http://www.kernicterus.org/" target="_blank">http://www.kernicterus.org/</a> When my children were born the bilirubin levels were relaxed, so neither of my kids were admitted, but were sent a bili blanket home. However, there were more cases of kernicterus being seen, so the AAP made the recommendations more conservative. In general, they now admit babies for levels of about 15, depending on age. Research has since shown that blankets don't work well, which might be one reason my oldest's levels didn't drop off until she was 6 weeks old. There is also an extremely rare for of hearling loss caused by jaundice, but it is very rare.<br><br>
What some of you are referring to is breastfeeding jaundice, and that is mostly a low level of jaundice that takes a while to clear in breastfed infants. The reason it takes a while to clear is because billi is water soluable, and breastmilk takes a while to come in, and a good breastfeeding relationship can take some time to establish. This kind of low level jaundice in a newborn is not dangerous, and most younger Pediatricians recognize this. I think it's the old school kind that freak out about jaundice.<br><br>
Any jaundice in the first 24 hours of life is not normal, and should be treated aggressively. That is usually called pathological jaundice because it is caused by something going wrong in the body. One of the most common reasons is ABO incompatibility or rh sensitvity.<br><br>
Also, about delayed cord clamping. It can cause higher jaundice levels, depending on how it is done. If you delay cord clamping, and the placenta is higher than the baby, then too much RBC's can get into the baby's system because there are not valves in the placental arteries like there are in the arms and legs. Their body knows what the RBC concentrations should be, so if it is too high, their body lyses, or destroys, the RBC's, producing jaundice, basically. The newborn liver is not able to handle a high level of billirubin until several days after birth, so it clears it more slowly at first. Add to thatthe fact that milk that doesn't come in for a few days, and your baby may end up with very high billi levels.
 

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I have found it so fascinating that we have turned physiology into pathology. Normal physiologic jaundice must serve a purpose right, well lo and behold bilirubin is an antioxidant?! Little it said about this but here is some interesting info<br><a href="http://www.sciencemag.org/cgi/content/abstract/235/4792/1043" target="_blank">http://www.sciencemag.org/cgi/conten.../235/4792/1043</a><br><a href="http://www.drjaygordon.com/development/pediatricks/bilirubin.asp" target="_blank">http://www.drjaygordon.com/developme.../bilirubin.asp</a><br><br>
like a pp said if baby is nursing well, wetting well, not lethargic, your in good shape!
 
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