Breast feeding and jaundice - any way to prevent it? Formula?

[HelenofSparta]

Hi
Pregnant with DC3. Both DC1&2 had jaundice as my milk does not come in until day 5. Is there any way to help milk come in sooner? (was breast feeding on demand constantly, but nothing there).
I didn't give up and ended up BF both until thy were 13 months old, but DC2 was v Ill with the jaundice so would like to prevent this happening again.
Friend in USA was not allowed to leave hospital until bellarubin levels acceptable and were told to offer formula to stop it.
So, should I offer formula this time and if so how much? Also if I give formula will my milk still come in so can BF after day 5?
Thanks

My milk didn't come in till day 5 with dd and day 4 with ds. Both had jaundice. It is a normal part of having a baby. Lots of bfing and access to sunlight will flush it out. And before day 5 they are just fine on colostrum. Of course if you're talking about v severe jaundice or jaundice that doesn't respond to bfing, then you take medical advice. But I wouldn't give formula to prevent it happening in the first place, certainly I wouldn't give formula when you're just starting out bfing.

I was told to start using a breast pump before labour started, as this can help milk come in sooner. I have heard that there is also some medication that can be taken which speeds milk up. But I can't remember what its called, you'd need to ask GP. And I think it is actually licensed for something else, but the milk thing is a side-effect. But I could be wrong there.

Sunshine helps jaundice I believe. Did it make your DC1&2 unwell? My DS2 was jaundiced, also ebf. My midwife said it wasn't an issue as he seemed healthy apart from being yellow. So we didn't worry about it too much, it subsided after a couple of weeks.

Both mine have had very noticeable but "normal" breastfeeding jaundice but, with DC2 in particular, have been like orange little pumpkins.

With DC2 she was nearly readmitted to hospital - bilirubin levels just below the threshold on the forehead test thing. It lasted for weeks and weeks. I almost had to persuade the midwives not to send her back to hospital anyway - they weren't happy. I didn't formula feed and she was never unwell with it (although people would peer into the pram and raise their eyebrows at her colour.)

I think DC1's jaundice was slightly less severe because she was a summer baby and was outside a lot. I tried to put DC2 next to sunlight by the window as much as possible.

I do know that lack of fluid can cause the more severe dangerous jaundice - is this the type you mean, directly caused by lack of breastmilk? That would worry me more. Could you ask midwife now about how to get milk in sooner? Do you have loads of colostrum?

Nb although midwives tell you to shove babies by the window, if it's vitamin d that's useful for jaundice, it needs to be directly on the skin. Through a window is apparently not much use for harvesting vitamin d.not much use in deepest winter, sorry!

I did wonder that too Whiteshoes..... so also used to put DC2 in her pram with her little face pointing to the very dim winter sun. but there is mixed stuff about it online...

There is a breastfeeding doctor in the US (Dr Jack something - newman maybe) and his view is that jaundice in breastfed babies is entirely normal and may actually be beneficial for reasons not entirely known....

DS2 was also a wee pumpkin and got a bit sleepy on day 3. i just cuddled him in skin to skin and encouraged him to feed. he was still an interesting colour, but it seemed to pass quite quickly.

Hello, mine were re-admitted as not just the usual BF jaundice that clears up. Winter and no sun didn't help. DC2 in hospital for nearly two weeks. V v sleepy and would not feed at its worst. Feet looked like a pin cushion by the time we left, poor thing.
Will look up the pumping per birth, thanks RikersBeard. Oohdaddypig, not much colostrum, why there was a prob I believe.

Ps have also been reading about delayed cord cutting, which is supposed to help....

sorry Helen...that sounds stressful. What did they do for DC2?

I recall reading somewhere about jaundice being worse if blood isn't allowed to flow from cord long enough - could be a load of rubbish but could you google it? DC2's cord was cut sooner than I wanted and I wondered if that could have made her jaundice worse.

I'm sorry but I've no experience about how to increase colostrum. I always thought milk came in when it was ready which for me was day 4.

..our posts just crossed re the cord! it's to do with transfer of blood.

I felt quite guilty re DC2 tbh as I just forgot to ask them not to cut the cord straight away.. was a bit out of it. althought we were lucky not to be readmitted I felt v stressed by the jaundice as they took bloods in hospital as bil levels so high within 36 hours. I think it was 10 weeks before it completely cleared.

there is also something about blood groups (mother and child) and increased suspectibility. I'm o positive and I think DCs are AB and that increases risk too...

I don't think formula will make any difference to be honest.

It's just anecdata, but my FF DD1 had much worse jaundice than my BF DD2.

DD1's cord was cut earlier than DD2's though - with DD2 the midwife waited until it had stopped pulsing.

Milk coming in is stimulated by the removal of the placenta and the baby suckling. A baby only needs tiny amounts of colostrum too in those first days.

My LO is 23 days, bf and had jaundice - borderline whether she would be readmitted but we tried the feeding plan the MW gave us and they came back every day to check.

She was V sleepy meaning she didn't wake for feeds which was the main prob. MW suggested if she didn't latch, expressing and giving via a bottle (every 2-3 hrs) since it was easier for her ie, no sucking effort.

Did that and she's now fine, bf no problem :)

Will obviously vary according to severity but I wasn't encouraged/told formula was necessary. I do know the pediatrician at the hospital likes the MW to tell people to use formula top ups as its easier (she told me its less admissions) but not always necessary.

GL :)