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Old 10-30-2012, 10:54 AM   #1
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Jaundice and formula/breastfeeding

My cousin had a baby girl last week and has been trying to bf despite crazy nurses and the docs saying to supplement (already!?). I went to the hospital to help get baby latched and just support her in general...then baby got jaundice and the docs tell her she has to bf for 15 min each side then give formula to clear the jaundice. Bc apparently it'll make her poop more and clear her system out.

She's a ftm already having latch issues and they tell her formula is necessary to make her baby healthy again. What the heck! I went to see her yesterday and she told me baby was giving her a hard time latching again and preferred the bottle. She'd gone 4 hours without nursing (and minimal formula) when I got there bc the mom couldn't get her latched and her milk came in so obviously she was uncomfortable. I explained to her that the point of the formula was to get more in her so she takes more out bc she will drink more and easier from the bottle. We decided to ditch the bottle and she agreed she would nurse longer than the "15 min" so baby would take in more. Her pedi told her yesterday to "supplement until I tell you to" which we both thought was ridiculous. Her milk is in, baby latches great and has plenty of wet and dirty diapers! And the formula actually made her gassy and uncomfortable.

Why oh why would you give an aspiring bf'ing ftm such bad info! If you give her formula and say the baby needs it to be healthy how many women will actually continue to bf?! I just get so mad at these crazy nurses and docs that don't know what they're doing! Hmmph.

Vent over.

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Old 10-30-2012, 11:00 AM   #2
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Re: Jaundice and formula/breastfeeding

I hate it when doctors give that advice! My son had moderately bad jaundice, and we got him over it without a drop of formula. The LC we had was against bottles, so for a little bit we supplemented with pumped milk in a plastic syringe... but really, with just getting as much breastmilk as we could in him, he got over the jaundice. (Well, that plus a billi-blanket he wore his first two days home.)
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Old 10-30-2012, 11:06 AM   #3
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Ugh, we got the same advice with DD. My milk took a LONG time to come in though (and she was visably yellow, lol), but still, I think it would have come in more quickly with more time at the breast. Needless to say, after 2 weeks of bottles + breast she preferred the bottle nipple, but luckily also would latch to a nipple shield, so that's how we nursed for the first 4 mos. Finally was able to ditch the nipple shield after a lot of work, but I can't help wondering whether it was all necessary, or just doctor CYA.

Good luck to your cousin and thank goodness she has you for support!!

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Old 10-30-2012, 11:38 AM   #4
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Re: Jaundice and formula/breastfeeding

Sounds so much like what I went through. I know so much better now, and I wish I knew then what I know now.

I thought my supply was too low and was supplementing with formula (I don't have issues with formula when it's needed -- I was formula-fed). My son was born in July, and will be 16 weeks old tomorrow. As of yesterday, he's been EBF for 3 weeks! Because he had extreme weight loss ( story here), I was supposed to BF him 15-20 minutes (I often did a lot longer, though, as long as he wanted!), and then formula.

We were up to around 24 oz. of formula a day, and suddenly toward the end of August he was only taking 16-20 oz. I was really worried! From then on he would have his formula often in the morning and then he'd come to me.

Little by little, he went down to 4-8 oz. a day, and then 3 weeks ago, on Sunday morning, he had his last 4 oz. of formula and I was determined to try to EBF since that seemed to be what he really wanted.

So far it's coming along well. I just wish I'd had more support from medical staff and even LCs early on! I had a lot of emotional support from family & friends, but they weren't very knowledgable about this side of the issue.

I'm so glad your cousin has someone like you to help her! I wish her the best!
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Old 10-30-2012, 12:09 PM   #5
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DD had high billi at birth and I was told the same thing.. Feed every two hours and give her formula so she'll poop the billi out. I didn't give her formula but used the nipple shield. The high billi makes babies lethargic so nursing is hard for them because they have to work harder. The shield allowed her to nurse easier. My milk took forever to come in (first baby). Eventually billi went away. Is it possible to lay the baby in the sun?
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Old 10-30-2012, 01:29 PM   #6
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Re: Jaundice and formula/breastfeeding

My middle daughter had really bad jaundice. She had a level of 29. She was in the NICU for four days. I breastfed the whole time. However, when they released her, she started getting bad again and so I did do the formula thing. I did 16 hours of just formula. Her jaundice left and I was able to nurse her again from then on. She never had formula again.

What kind of latching issues is she having? Another thing she could do is use a syringe with a bit of formula just to take the edge off the hunger and then latch the baby, or even have her latch and then slightly slide a syringe in the side.

By the way, I am completely for nursing, not formula, but I know that the formula helped my daughter. Janudice can be very dangerous depending on the level.
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Old 10-30-2012, 01:32 PM   #7
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Re: Jaundice and formula/breastfeeding

if I was in this situation, I would get the baby out in the sun...

and if I felt like I really needed to supplement, I would get one of those nipple straw things, like this, to keep the baby at the breast. http://www.medela.com/IW/en/breastfe...g-devices.html
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Old 10-30-2012, 02:01 PM   #8
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Re: Jaundice and formula/breastfeeding

I've heard that story a dozen times. The good news is that it's definitely possible to work past it and continue to breastfeed, but I've also known personally several women who were railroaded by this advice and did not continue to breastfeed. It makes me sad that so-called medical professionals are not more willing to advise women to nurse their babies as much as possible before moving onto recommending formula.
My second was jaundiced, but we nursed constantly and put him in the son and it cleared up just fine with no scare tactics from my midwife.
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Old 10-30-2012, 02:39 PM   #9
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Re: Jaundice and formula/breastfeeding

Elevated levels of bilirubin can be very dangerous. High enough levels for long enough can cause permanent neurological damage. Jaundice needs to be taken very seriously for the ultimate health of the child.

Babies with jaundice become very sleepy as a result. This means that they often are very poor nursers. Keeping them awake long enough to get sufficient breastmilk in those early days can be very tough to do. Breastmilk is also digested more fully than formula which means that those babies often have fewer and smaller bowel movements than babies on formula which means that formula fed babies generally clear the bilirubin from their bodies more quickly than breastfed babies (which is good for baby). Latch problems can be common and part of the reason is that baby is too sleepy to get and keep a good latch. Pumping can be an alternative that works for a lot of people. I addition, sunlight or biliblankets help breakdown the bilirubin so that it can be excreted.

Switching to formula is fairly standard advice because of how dangerous longterm exposure to high levels of bilirubin can be. It is absolutely possible to breastfeed your way through jaundice and for baby to be fine. But, please don't just dismiss the advice as bad advice.

My middle child had a borderline bili level when we left the hospital. We went to the doctor about 36 hours later and his level was higher. We were advised to get him in the sun and nurse as much as possible (or supplement). His levels continued to rise for the next day or two and ultimately we had to use a biliblanket on him 24/7 at home for 5 days with a visiting nurse coming in daily to do a heel stick to check his levels. We got through it without supplementing. However, it was something that we continually reevaluated because if my milk hadn't come in quickly and if we couldn't keep him awake enough to nurse or he wasn't having enough bm's, then we knew that supplementing may well be more important for his longterm health than exclusively breastfeeding. We were careful to stick with advice from our doctor, LC and the information we received from daily bili level information. It isn't necessarily bad advice that she is getting and certainly shouldn't just be blown off as an ignorant doctor.
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Old 10-30-2012, 03:00 PM   #10
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Re: Jaundice and formula/breastfeeding

Quote:
Originally Posted by z2akids View Post
Elevated levels of bilirubin can be very dangerous. High enough levels for long enough can cause permanent neurological damage. Jaundice needs to be taken very seriously for the ultimate health of the child.

Babies with jaundice become very sleepy as a result. This means that they often are very poor nursers. Keeping them awake long enough to get sufficient breastmilk in those early days can be very tough to do. Breastmilk is also digested more fully than formula which means that those babies often have fewer and smaller bowel movements than babies on formula which means that formula fed babies generally clear the bilirubin from their bodies more quickly than breastfed babies (which is good for baby). Latch problems can be common and part of the reason is that baby is too sleepy to get and keep a good latch. Pumping can be an alternative that works for a lot of people. I addition, sunlight or biliblankets help breakdown the bilirubin so that it can be excreted.

Switching to formula is fairly standard advice because of how dangerous longterm exposure to high levels of bilirubin can be. It is absolutely possible to breastfeed your way through jaundice and for baby to be fine. But, please don't just dismiss the advice as bad advice.

My middle child had a borderline bili level when we left the hospital. We went to the doctor about 36 hours later and his level was higher. We were advised to get him in the sun and nurse as much as possible (or supplement). His levels continued to rise for the next day or two and ultimately we had to use a biliblanket on him 24/7 at home for 5 days with a visiting nurse coming in daily to do a heel stick to check his levels. We got through it without supplementing. However, it was something that we continually reevaluated because if my milk hadn't come in quickly and if we couldn't keep him awake enough to nurse or he wasn't having enough bm's, then we knew that supplementing may well be more important for his longterm health than exclusively breastfeeding. We were careful to stick with advice from our doctor, LC and the information we received from daily bili level information. It isn't necessarily bad advice that she is getting and certainly shouldn't just be blown off as an ignorant doctor.
I really really like this post
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