Newborn with Jaundice Due to Breastfeeding

I have heard the exact opposite. I have 3 kids, 2 of which had jaundice and all the docs even the nicu said that breastfeeding is the best way to get the bilirubin out of their system as well as putting them in indirect sunlight at various times during the day. In my opinion, DO NOT stop breastfeeding there is not reason to discontinue it, it's the best thing you can do for the jaundice. Maybe you heard this from some first year resident or something but I wouldn't follow this advice, just my opinion. Good luck and I hope the jaundice supsides soon. Oh, and the more they poop the quicker it gets out of their system too so nurse away!
J.

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Please read these links regarding breastfeeding and jaundice. In most cases, you DO NOT need to formula feed during this time. If they are not admitting her, her levels are most likely lower than 20mg and she will be just fine. Just nurse, nurse, nurse. Good luck and congrats!
http://www.askdrsears.com/html/2/t029600.asp
http://www.kellymom.com/newman/07jaundice.html
http://www.kellymom.com/babyconcerns/bfhelp-jaundice.html

Oh my goodness! What terrible advice! The BEST cure for getting rid of the bilirubin which causes jaundice is to breastfeed. Nurse, nurse, nurse as much as possible. Many babies have jaundice as newborns (including my two daughters). The breast milk helps flush out the bilirubin. That being said, if your milk isn't fully in yet you could SUPPLEMENT with formula for a few days; just make sure you continue to nurse frequently to build your supply up. I did not give either of my daughters formula, and their jaundice cleared up within two weeks.

Hope that helps!

M.,

I have had three children and they all have had jaundice. Each time they wanted me to go feeding with formula. But I refused to and ended up supplementing with formula. My first I would nurse and then supplement with a plastic syringe. Second one I would breastfeed and the nurse or my husband would use a syringe attached to a tube that we would be slid into their mouth next to my nipple. My last one is 7 months old and I would nurse the baby and then we would give him a
2 ml bottle. We have never had a problem with nipple confusion. Good luck. By the way, did they tell you that you should lay your daughter in direct sunlight. Leave her just in her diaper and sit by a window, that helped my first one pass the bilirubin's faster.

J.

M., I would strongly advise you not to stop breast feeding!!!!Call a local Lactation counselor and put your baby in the sun for some extra vitamin A&D.I cannot imagine what you're going through , tho I have serious concerns about a doctor who would advise you to stop doing the most natural and best thing for your child! The la leche' league has numerous woman and counselors available to help along with Physician support. Check that out and the very best of luck to both of you!!!G.G.

My little one had jaundice, but we were able to keep breastfeeding through it. The important thing is to keep your milk supply up if you suplement. Get advise from www.kellymom.com They are really good with this stuff. Post this as a question there with lots of detail. They are so knowledgable, but will need the specifics (age, counts, etc.)

Hi M. -
I had a similar situation. My son was jaundice and I was told to stop nursing for 24 hours. I was so scared that he would not go back to the boob after getting formula for the day. 24 hours doesn't seem that long but that is a lot of feedings for the little one. We went to formula for the 24 hours and he went back to nursing just fine. My sons numbers went down but I will never know if it was due to not nursing or it just being another day for his body to work it out. It seems that you have mixed reviews so just do what makes you comfortable. If she is going to be a boob baby - she will go back to the boob. Good Luck!!

I was told to give the baby about 2 tbsp of water before each feeding and that would clear it out faster.

First of all hats off for you for breastfeeding! Its not an easy thing today and many mom's welcome the opportunity to throw in the hat b/c of challenges...so you are already showing your amazing love to this child by your committment and concerns regarding breast feeding...

I breastfeed both of my kids (9 months for the first and 10 months for the second)...Both of our kids had high bilrubin/ jaundice issues...Don't worry about stopping...just buy/borrow a breast pump and pump at the times you'd normally feed her in order to maintain your milk supply...

...give her the recommended amounts of formula/or whatever the doctor recommends (soymilk etc.)...until the levels get to normal... Most babies welcome the opportunity to have breast milk...so your baby will likely do fine... He/she may have difficulty with the latching (and you might too) BUT don't confuse that with him/her not wanting your breast milk...they may simply have to relearn the latching skill... Don't give up if you hit latching difficulties...just say to yourself that its a matter of time...Your baby will relearn the skill in no time...after all they are growing and want food! There is a book called...the Art of Breastfeeding... I recommend it for you...

Just relax and take one day at a time...that means first just take care of the bilirubin which is the most important health concern for you at the moment... then tackle the breast feeding issue....

...as far as the bilirubin...there are bilirubin light blankets that your doctor can prescribe/authorize for you...You can use them at home with your baby...ask your doctor for the insurance authorization...You may also hold the baby naked (down to the diaper) in direct sunlight several times during the day...You can stay inside your home and sit by a window or as the weather gets nicer you could go outside...

Blessings

M.

My baby had this. She was under a light at home for almost a month. I had to supplement every other feeding with formula. At the end of the month, she went right back to nursing full time. The formula worked, something to do with the higher levels of iron and other things. It is a little difficult, but I would pump when you can just to keep the milk supply up. Check with your doctor about saving it, or if you need to dump it. Good luck

Check out www.kellymom.com for further info. I think you are being wrongly informed.

http://www.kellymom.com/newman/07jaundice.html

My first daughter was born 3 1/2 weeks early and developed jaundice too. This was 23 year ago, so I don't remember all the details, but we did come through it and I nursed her for nearly a year. She had to be re-admitted for a week to stay under the bilirubin lights (probably released too soon the first time). In the hospital they used bottles to give her formula and I continued to nurse, so our situation wasn't exactly like yours. In hindsight however, I do think she developed some "nipple confusion" and that worked itself out once we were home and back to nursing only. A friend of mine switched to nursing after starting her baby out on a bottle. So she didn't even start nursing until her daught was a week or two old - and her daughter took to it easily. Go back to nursing only when you get the green light from the doctors, and with persistence on your part, your baby will most likely go back to nursing. Good luck and congratulations on your new baby!

My son was also jaundiced for a few days or a week after he was born, but never did the doctor tell me to quit breastfeeding. I was also told to put him in sunlight as often as possible, and I nursed him as much as possible, though breastfeeding was a struggle for the first week or so with him. Keep it up! And if your doctor insists on the formula, seek another opinion. I definitely don't think that's the best option - breast milk is ALWAYS best and has EVERYTHING your little girl needs!

I think it's ridiculous that any doctor would suggest that you stop breastfeeding. You should take her in daily for a dose of light to get the levels down. You should not stop feeding. What practice are you attending? It infuriates me to hear this type of advice, from a doctor nonetheless. If I were you, I would say NO WAY and seek other options like light therapy AT HOME. ( they do have the ability to do this!)

I didn't read the other responses, but know this is common. It was the same deal for me with my second child. The breastfeeding didn't cause the jaundice. The formula just help the to eat a lot and go to the bathroom more to rid their little bodies of the billrubin. Just pump for now and store the milk in the freezer for later. Then when the jaundice clears, you can go back to nursing in a few days, just like I did.

M., your baby's bilirubin levels has nothing to do with breast feeding. It has to do only with your baby's liver functioning. Perhaps the doctor's asked you to stop breast feeding because a formula if synthetically balanced and may have more of what your baby needs.

I would get a 2nd opinion from another specialist in a couple of days after the doctor checks the bilirubin levels if they are not stabilizing at normal levels.

Here are a couple of excellent articles that I found online. They suggest the opposite of what your doctor recommended. If I were you I would start doing more reseach.

http://www.kidshealth.org/parent/pregnancy_newborn/common...

http://www.medscape.com/viewarticle/541770_5

http://www.nlm.nih.gov/medlineplus/ency/article/001559.htm

M.

Wait wait wait...I'm confused. Jaundice DUE to breastfeeding? Stopping feeding for 24-48 hrs? I may be reading this wrong and if so, I apologize.

Both of my boys had jaundice when they were born and the only thing I had to do with regard to feeding was to feed, feed, feed. I DID have to supplement with formula to make sure that my older son (Jacob) was getting enough. Jacob was also in a "bili-blanket" at home for a few days. But, with my second (Ryan), he was SUCH a good nurser (and my milk came in FAST) that he never needed any formula.

So, when Jacob was being supplemented with formula, I was pumping to get my milk to a) come in and b) to save. I would feed him EBM as often as I could and also the formula. He was able to do the bottle for the short time and then was more than willing to go back to nurse after we were in the clear. Your little girl may have a hard time (some do) but working with a Lactation Consultant can really help with this.

I would clarify with your pediatrician exactly what you are supposed to be doing with regard to feeding.

Hi M.,
I have 4 children and 3 out of the 4 had jaundice. My third son was put back into the hospital for a week because his bili level was 24, which is seriously high. I have heard that pitocin which is used to induce labor is what is causing so much jaundice in babies. I had pitocin with all 3 of my babies that had jaundice and did not have pitocin with my one child that did not have jaundice. I have heard that babies can get jaundice from breast feeding but I don't know the reason why. When a baby has jaundice they want to get as many fluids in the baby's body as possible and that's why they often ask you to wait on breastfeeding. I would suggest bottle feeding and just pump and store your milk in the freezer, just to make sure the baby is getting lots of fluids. I know now they say not to give babies water but they had me give my son water also. My son who was in the hospital was put on an IV. All the fluids help flush the body out and get the liver working right. Don't worry about the baby having nipple confusion, she probably will if you are doing bottle for 48 hours. Don't worry you can get her back on the breast, it won't probably be easy but if that's all you offer her she will finally give in and take to the breast. She is so little you should be able to get her back on breast feeding. Breast milk is so good for the baby especially the first 6 weeks!!
Did they tell you to take her clothes off and lay her in the sun near a window in your house, not outside of course. Don't put her face in the sun just her body. And make sure that she isn't there long enough to get sun burn. Push the fluids. My doctor had me bring my babies back in to the office each day to have a bilirubin test. Once the levels start to fall they usually don't go back up again, because the liver is finally working. Also, when their jaundice is high they tend to sleep a lot, so wake her up when it is time to feed. That way she will be getting the fluids she needs. Don't worry, I am sure she will be fine, but it is scary when your baby is sick and you have no idea if they are getting better or not. Congratulations on your new little baby girl!!!!

M.,

You will undoubtedly get a lot of responses on this :-)

First, don't panic. Most babies get a touch of jaundice and it self corrects. The important thing is that you are nursing like crazy to stimulate production... even if baby is not at the breast, you will still need to pump. contact a lactation consultant at your delivering hospital for advice on how often and how long, etc. secondly, the reason why they are telling you to supplement is because most breastfeeding jaundice is due to lack of supply, and not enough fluids to help secrete the bilirubin. I do not believe the liver begins functioning on it's own until birth, so again, don't panic... most babies experience a certain degree. I think it's a little too soon to say that you should give up breastfeeding or say your new baby is failing to thrive, it IS the best thing you can do for your baby :) Secondly, if your baby needs to take a bottle for a couple days, she should adjust quickly back to the breast once her levels are up. Is it possible to get one of those things that you wear... it has like a tube that would supply supplement to baby, but keep her at the breast... i don't know what they're called. My son was breastfeeding for a week, then we stopped... then I had a change of heart around 6 weeks and wanted to try to relactate, even if he wasn't getting his sole nutrition from breast and he took the nipple quite well... I was never able to fully relactate - this was my fault. His reflux issues were incredibly stressful - but enough about me ;-)

Here is what Wikipedia has to say about 'breastfeeding jaundice' - some of it greek to me, but your doctors and a lactation consultant can better help you understand what's happening and why.

The term breast-milk jaundice refers to jaundice in a newborn baby who is exclusively breastfed and in whom other causes of jaundice have been ruled out. The jaundice appears at the end of the first week of life and hence overlaps physiological jaundice. It can last for up to two months. Several factors are thought to be responsible for this condition.

In exclusively breastfed babies the establishment of normal gut flora is delayed. The bacteria in the gut convert conjugated bilirubin to stercobilinogen which is then oxidized to stercobilin and excreted in the stool. In the absence of sufficient bacteria the bilirubin is de-conjugated and reabsorbed. This process of re-absorption is called entero-hepatic circulation.

The breast-milk of some women contains a metabolite of progesterone called 3-alpha-20-beta pregnanediol. This substance inhibits the action of the enzyme uridine diphosphoglucuronic acid (UDPGA) glucuronyl transferase responsible for conjugation and subsequent excretion of bilirubin. Reduced conjugation of bilirubin leads to increased level of bilirubin in the blood.

Lipoprotein lipase an enzyme present in breast-milk produces increased concentration of nonesterified free fatty acids that inhibit hepatic glucuronyl transferase which again leads to decreased conjugation and subsequent excretion of bilirubin.

Breast-milk jaundice does not usually cause any complication like kernicterus if the baby is otherwise healthy. The serum bilirubin level rarely goes above 20 mg /dL. It is usually not necessary to discontinue breast-feeding as the condition resolves spontaneously. Adequate hydration should be maintained by giving extra fluids if necessary.

Good luck and CONGRATULATIONS!!! :)

I am surprised that your doctor suggested to stop breastfeeding. All three of my children had jaundice when they were born. In the hospital they were put under the blue lights occasionally to bring down the bilirubin levels. Two of them came home with a biliblanket, which you wrap them in and plug it in for much of the day. With one of the children, the nurses had me cupfeed the baby formula to supplement the breastfeeding. This way it was not confused with a bottle nipple and still got supplemented. I was surprised how the newborn would take the formula from a small cup (which I of course had to raise to his mouth to drink.
Good luck!

This happened to me and I was so sad to not be able to breastfeed. Before you do anything, contact a lactation consultant. Usually you can get some free advice from the one at the hospital. I supplemented with formula for a few feedings, pumped, and was able to continue breastfeeding with no problems...for 2 years! Good luck!

M.:

My daughter was jaundice....just put her in the carseat and put her in indirect sunlight for a several minutes per day. I did that per my doctors orders and she was better in just a couple of days.

K.

My son was under the lights at home and he also spent a lot of time outside but I did not stop breast feeding him. He was fine in a week. But he was born in July and it was a lot warmer outside.

S.

I have never heard of such a thing. Breastfeeding is supposed to be the best food for your child. I think I'd maybe get a second opinion if I were you. I breastfed my daughter for almost 18 months and the thought of giving her formula made me sick.

Good luck!

Do NOT let them make you stop breastfeeding your baby. This is a critical time for you and for her to establish your breastfeeding relationship and for both of you to get the hang of it. It also is important to fine-tune your milk supply. Breastfeeding does not "cause" jaundice, but it can delay it from being resolved (some kind of enzyme messes with things). My 6-week-old son was jaundiced as well, and we were able to wait it out. If the bilirubin levels are not dangerously high, a combination of time and sun exposure should take care of it. Our pediatrician also said babies "poop it out," so that's another reason why you should continue to breasfeed your daughter.

What I had to do is nurse, nurse, nurse...and suplement at least an ounce of formula at each feeding. We work with a lactation consultant and they taught us to give the formula from a little cup (like a medicine cup) so that she wouldn't have any nipple confusion.
I would nurse her and then my husband would take her and give her the little cup with forumla in it, he would put it up to her lips and tip it just enough that she could "lap" the milk with her tounge.
Because you aren't usually making much milk at the beginning sometimes they need extra food/liquid to help get rid of the jaundice
Please talk to a lactation consultant, I don't think you need to stop breastfeeding, but you may need to suplement.

My preemie also had jaundice, and we stayed an extra day in the hospital too (he was 5 1/2 weeks early). We also had a light paddle at home for the rest of the first week that wrapped around his belly and plugged into the wall (delivered by home health, same blue light as what he had in the hospital). My pediatrician asked me not to breastfeed until the end of the next week, so I pumped around the clock (every 3 hours) and bottle fed him. Breastfeeding him was never easy, for the whole 6 months I did it, and I don't know if it's because those first couple of weeks are crucial or what the cause was. But I think if it's only 24-48 hours that you have to abstain, you will be ok - just pump & bottle feed then start nursing her again as soon as you can. I think the idea is that you need to be sure she's getting enough food during this time, and by bottle feeding, you can monitor her intake. Hope that helps!

Good Morning M.,
I had a very similar experience with my 1st child-now almost 10 yrs.old!I stopped breastfeeding for 2 days. For that 1 or 2 days I just pumped and saved up the breast milk (handy for later anyways). I gave her the powdered formula-Dr. said it would be easire on her stomach. It was. Her bili level dropped after that. I went back to nursing her just fine after. It will be OK. She did breastfeed after that, but always preferred the bottle.
I am a Stay-At-Home mom to 2 beautiful girls. 8 and 9 1/2yrs. I volunteer alot. I have a great husband who works 2 jobs, coaches soccer, and heads up our Brownie Troop!

same exact thing happend to me. my peds dr said to it was because of the feedings and my ob told me he was nuts. go figure. everyone has there own opinions. i breastfeed with like every 3rd feeding and pumped the other times. that got me through the 2 days. and the baby was fine. open the windows and doors and let as much natural light in. it works the same way as the bili lights in the hospital. hope everything works out ok.

Sunlight! Sit in the window w/ baby w/ as much skin as exposed as comfortable.

That is really odd that your doctor said to stop breastfeeding! When my son was jaundiced, I was told that the best thing to do is breastfeed as much as possible so their system adjusts and is able to get rid of the bilirubin as quickly as possible. Around day 10 the levels are supposed to be at their highest, so after then, you should see a decrease in your baby's levels. My son got up to 19.4 and then naturally his levels decreased and he was absolutely fine - without any lights or interference except a lot of breastfeeding and some sunlight. I wouldn't worry too much - this is totally normal and your baby will be fine! :)

Just wanted to throw in my two cents. My baby got jaundiced within the first few days of birth and it was very scary and awful to sit through those dang pin pricks. I wanted to die. I was breastfeeding but that is not the cause as you already know. (I also had a totally natural birth so it had nothing to do with drugs). It was because he was falling to sleep before he was done feeding so he wasn't really pooping enough to get the bilirubin out. The bilirubin actually makes them sleepy too so it's like a vicious cycle. Also it they are having trouble latching on which is common in the beginning too. I had to put my little one in the hospital under the lights cause his count was so high. I supplemented with formula at the insistence of the nurses but I kept breastfeeding and stayed with him the entire time. In the end everything was okay and baby had a suntan, kept breastfeeding and in the end wouldn't take a bottle at all. Good luck to you and your baby! Sounds like all is on the road to recovery.

My son was BF jaundiced for about 6-8 weeks (he was like George Hamilton in pictures). My doc did not recommend that I stop breastfeeding. She said it would go away on its own and it did. Look it up at www.kellymom.com for more information. A very helpful BFing website. Good luck! (oh - and the sunshine thing too also seemed to help. we would set him up in our front sunroom in just his diaper for 30 minutes - if it was nice out we'd sit outside for about 10 minutes so he could get some sun. that is supposed to help get it out too.)

My daughter had jaundice when she was born as well. This is something you need to deal with, if the numbers go up too high it can cause real problems. Google it!

Have they sent the lights home with you? They sent out a home health nurse to give us a light that wrapped around my baby and she wore that for a few days to a week (I can't remember now, she's 8). The Dr. suggested that I stop nursing for a few days, but in the end I did not nead to. One thing I suggest is that if they give you the wrap around light be sure to get a picture of her wearing it at night, it is the most unusual thing! Also having her in the natural sun light is good. I would strip her down to her diaper and lay her in the sun.....in a window since she was born in February!

I did nurse her for a long time and also had to work. I was most fortunate that she would nurse with me and take a bottle from child care (breast milk or formula if I could not pump enough). The biggest thing is that if you stop nursing for a couple of days you do not give her the bottle, have your husband or someone else feed her. My daugther would never take a bottle from me. I would conact LaLeche Leauge also, they are a wealth of information!

Good luck and God bless!

My son was jaundice when he was born b/c his liver was not fully developed. He had to be on special formula for a little while, but then I was able to breast feed after a few weeks. I pumped close to his feeding schedule to keep milk production available. I was also advised by the doctor to try to sit in the son by a window to allow natural vitamin D while feeding, this was to help with the jaundice.
Hope this helps.

My third son was jaundiced and in the hospital under the lights for 48 hours -- I had him out every hour to nurse him. They wanted me to formula feed because they said it was the breast milk that slowed the jaundice from exiting the body. However, I firmly believed breast milk to be the best thing for my son and all was fine. He is four and perfectly healthy. My sister too just had a baby and within 24 hours of her birth they had her baby under the lights. She was brought the baby every 3 hours to be breast fed and they alternated with the formula. Within 5 days her levels were where they needed to be. My sister's baby is a "coons" baby whereby the mother and father have opposing blood types -- which causes the levels to peak 72-96 hours after birth. All babies apparently are born with some level of jaundice -- it was my experience to continue to nurse and not formula feed. My sister's choice was to alternate. Do what is best for you and either way trust your instincts -- your baby will be fine either way. Good luck and congratulations!

Yes I had the same experience. When my daughter was born whe jandiced and they put her on home health bilirubin lights so she would still be with me...she eventually got better, but at that time no one mentioned the breastfeeding connection. When my son was born 4 years later, again he jaundiced and we started with "sun light" when there was no change my pediatrician suggested the breast mild connection given my daughters history, so we fed him with formula for about 24-48 hours and it worked, I pumped during those 2 days...got more sleep too...and afterwords he went on to happily nurse as a matter of fact for over 3 years.

Hi M.,

My little one had jaundice in the hospital too. (I couldn't nurse once we got home because of medication for complications). But, our ped suggested letting her nap in front of a window to get exposure to sunlight without having to get the UVA/UVB exposure. That had it cleared up in a day or two.

Good luck!

I had the same issue with my daughter but maybe not as severe. The doctor recommended me to supplement formula for two feedings a day. This helped out and it was only 2oz. I continued to breastfeed also. Will your doctor let you do both, maybe do half breast and half formula until the levels go down.

I have never heard of this, but who knows because my daughter had jaundice and the nurse at the hospital told me that it might be because of her blood type was so much different than mine. There are a lot of factors that can influence it I guess. I don't think stopping nursing for 24-48 hours would be a good thing, I'd say maybe nurse her more often, wake her to feed her and do it like every 2 hours???