Wednesday, August 24, 2011

The Jaundice Dilemma and Good Questions to Ask

When you are a new Mom, you want nothing more than a healthy baby to take home.  Many times the medical condition such as Jaundice is a familiar term and something parents deal with as they learn to feed their baby.  Luckily it is not the threat it once was.  Jaundice is the condition that turns a baby's skin and eyes yellow.  In technical terms it means an elevated bilirubin.  Here's a complete explanation of Jaundice by Dr. Jack Newman:  Breastfeeding and Jaundice

One of the issues that a Mom is conflicted with is that the doctor typically tells her that she needs to stop breastfeeding and give formula to the baby because of Jaundice.  But if you understand the basic notion that babies with Jaundice need to feed frequently in order to flush what causes Jaundice in the first place, why would telling a Mom to give formula be the best option?  Formula in itself is difficult for a baby to digest, even less by a very newborn baby with a tiny stomach size.  It is a harder food to process since it is not compatible with human babies (human milk for human babies is).  So why do doctors tell Moms to formula feed a Jaundice baby?  That is a mystery that I will never understand.  Could it be the lack of knowledge?  What about not having enough time to assess how breastfeeding is going?  If doctors could take just a few minutes to assess breastfeeding and encourage a Mom to breastfeed more often to help her baby lower her baby's bilirubin levels, then why not do so?  Is it just easier to tell someone to feed x amount of formula just to guarantee the amount a baby eats?  Perhaps.  But even so wouldn't breastmilk be the preferred food in the bottle.  Many newborns have a hard time digesting formula and end up with a harder elimination process.  So if the goal is to get baby to eat and poop more often what do Moms need to do?  They need to avoid formula that can constipate and make babies sleepy, and breastfeed more often.  Now if only the AAP could get more doctors on-board with this...since we can't change that, what about becoming more active patients in the doctor's office?  Here are some suggestions:

If your baby is diagnosed with Jaundice, be sure to ask your doctor the following questions before feeding formula to your baby:
- I am very committed to breastfeeding, can you explain why formula is the only alternative?
- How long do I need to formula feed my baby?
- Help me understand what are the benefits of formula feeding my baby because of the Jaundice?
- What if I feed the baby my milk in a bottle instead?

Asking these questions can help your doctor realize how important breastfeeding is to you.  Even if the recommendation still comes down to giving your baby formula for a short period of time, then be sure to follow what La Leche League calls the 3 Keep's:  Keep the baby fed, Keep the milk flowing, and Keep trying.  Once your doctor has given you the green light to resume breastfeeding, then you will have the ability to do so. Don't give up and play an active role in your child's medical care from day one because not even your doctor is perfect and they need a little reminder once in a while.

Our Peer Counseling program sees many cases of babies with Jaundice that thrive better on breastmilk than they do on formula.  Typically with formula you get drowsy and constipated babies.  On breastmilk, babies feed often, poop often, and thrive.

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