Bf, Jaundice, Supplement questions-long
I had my baby boy on 12/31. He was full term just a small baby at 5lbs 11oz. He had a little bit of jaundice which i hear is normal in most babies. We went home on sunday and had a doc app. on monday. When we left the hospital he was 5 lbs 4 oz and when we went to the doc he was still 5lbs 4 oz. The doctor said that the jaundice was getting worse and to go to the hospital for a blood test. She also said to supplement with formula, which devastated me because i did not want to use formula at all. DS has had a great latch from day one and has never cried because he wasnt getting enough while i waited for my milk. We picked up a bottle and had smaples at home. He kept refusing the bottle (yay!) and when he finally did take it he hardly ate anything! After that he was crying for the rest of the night with bad gas and just upset. Nothing worked except nursing. Anyways i have not given a bottle since because i feel he doesnt need it. He has been having dirty diapers, and the jaundice is almost gone. He feeds every 2 hours and never acts hungry. I did not want to mess up my supply or his latch, but i need reassurance that i was right with what i did. Also it seems that they recommend supplementing formula to every baby.
Has anyone been in the same situation as me? If so what did you do?
TIA
Re: Bf, Jaundice, Supplement questions-long
It sounds like your situation is very similar to what I experienced with my son. He had jaundice for a few weeks, but DH and I did not want to supplement...so we didn't. We were told to supplement before we left the hospital and at our first visitto the pediatrician. We were at the pediatrician 4 or 5 times in the first 2 weeks and were sent to have bilirubin checked at the hospital. His levels were only one point away from being out of the "average" range, and the pediatrician recommended breastfeeding as often as possible if we were not going to supplement. Since our son was on track with diapers, we decided to wait. Everything was fine and I am glad we decided not to supplement. I think supplementing is an easy way for pediatricians to help babies get over their jaundice quickly. But, as my doula reassured us, as long as the baby is thriving (dirty diapers & maintaining/gaining weight), there is no need to supplement.
I have found that doing a lot of reading and research of my own about breastfeeding helps me know how to discuss things with my pediatrician. We also use an office with multiple pediatricians, and if one doctor recommends something that seems not "breastfeeding friendly," I make sure to make my next appointment with a different doctor in order to gain a different perspective.
I had a similar situation to this. LO was 5 lbs at birth (she was a late pre-term infant) and jaundiced when we left the hospital (day 3), but okay enough to go home and be checked the following day. We were advised to supplement some formula since my milk hadn't come in (LO was too tired/weak to suck efficiently when she was BF). I was devastated. I really didn't want to...and was very hesitant.
LO ended up being hospitalized and under the lights because her tbili skyrocketed. We supplemented with formula, but the LC and Pedi were very pro-BF and encouraged me to BF while supplementing with a tubing device to stick in the side of her mouth while she breastfed. (Prior to the hospitalization, the LCs taught DH to syringe/finger feed her so as not to confuse her with the bottle). I pumped like crazy as well and when it finally started coming in larger amounts they told us to supplement with my BM while she was BF. (Even when I only had a little milk, they had me mix my BM with the formula).
So to sum up our experience, we did have to supplement with formula for a short while. We did what we needed to get her healthy and out of the hospital. It only took her a short while before she was exclusively on BM. With that said, your pedi really should be getting labs to justify certain treatments though. And if you're concerned about the bottlefeeding, ask an LC about different ways to supplement than the bottle. GL!
I'm going to go out on a limb and assume you're not a doctor, but you seriously should not be dispensing these kinds of numbers without reference to the age of the newborn. DH is a pedi and totally supportive of bfing through jaundice, but it's NOT that cut and dry as stating 2 or 3 different number cut offs.
Also don't forget the reason why we "freak the heck out" about jaundice: high enough levels result in brain damage, completely 100% preventable brain damage. So while I'm totally on the side of not intervening with formula until you know that they're not getting enough bm and/or determine bfing jaundice with as much certainty as possible, I think you're being too dismissive of why it IS a big enough deal to get concerned and want to intervene before you're walking on the edge of the danger line.
I suggest we PM if we want to discuss this further, but I'll just stick with some very general points here:
1) Stop using numbers like they're set in stone. They're not, and the age of the newborn is very important when you're talking about how dangerous any particular number is. You can argue with the Bhutani nomogram and say you think it's overly conservative, fine, but you can't ignore age.
2) You haven't even specified your medical qualifications (if any). I think it's only fair since you're trying to cite things like research without links, that you clarify if you have an RN, MPH, MD, or just feel informed based on what you've read.
3) Have you even heard of bfing jaundice which I mentioned in my last post? There are some (yes, rare, but some) situations where temporarily removing bm can be important.
We are in total agreement on the general mistreatment and misinformation that's out there with regard to HOW much intervention is needed. I'm really uncomfortable with the way you're trying to 'educate' others without links to what you've found or stating your qualifications, and your absolutes are just as bad as those who use absolutes on the other side ("never stop bfing/give formula" vs the ignorant/impatient docs who espouse "always give formula").