Breastfeeding jaundice

[emelsie]

My newborn daughter is 8 days old , midwife referred me to hospital as she was quite jaundice looking , they did the blood test and it was just under the levels needed for phototherapy, so they want her back in 24 hours to repeat.

I'm breastfeeding on demand and they have put a feeding plan in place , saying I need to express or formula feed a certain amount every 3 hours , I really don't want to do either (especially formula ) as breastfeeding is going well and I don't think her not getting enough milk is the issue , she seems to feed well , has plenty of wet and dirty nappies and hasn't lost any birth weight which contradicts them thinking she may not be getting enough milk surely?

Any advice?
Thanks!

I think it's just that you need to feed lots to get the bilirubin levels to reduce.

I was on a plan feeding even more often than that because of jaundice in a newborn. I would make sure she's getting a good feed every 2.5 to 3 hours if you don't want to express and measure it. I'm no expert though.

The challenge is that at the start of breastfeeding the volumes of milk transferred to the baby are less than the volume of milk a formula fed baby would get. Whilst this is fine (breastmilk/colostrum are very concentrated so the same volume isn’t required) it means the jaundice can persist longer because the bilirubin needs to be literally flushed out of the body with fluids. So whilst she may be getting enough milk to not lose weight, that may not be enough for her to clear the jaundice.

You need to ensure your feeds are effective and your latch is good and feed as often as possible for the next 24 hours.

Bilirubin normally peaks around 4-5 days and then should start to subside after peaking. It can be dangerous - whilst jaundice is common and normal to a degree - levels that require phototherapy need to be treated as if they continue to rise they can cause serious and lasting damage. I’d see what the levels are tomorrow - if they’re still rising then I’d recommend thinking of formula top ups as a medicine to help her get better. At no point should you need to stop your breastfeeding but a day or two of additional fluids (formula) on top of your breastfeeding could help prevent her needing more drastic treatment.

My dd was on a feeding plan of 28ml expressed milk every 2 then 2.5 then 3 hours for the first 3 weeks of her life. She was very sleepy though and did need phototherapy.
The pediatrician wasn't happy with just bf as my baby was very tired and kept falling asleep so her suck was poor. With the 28mls they were able to monitor how much she was getting and with each feed she peeked up a bit.

We managed to get to ebf and a non jaundiced baby by 3 weeks. I really wouldn't worry about nipple confusion (if that's why you don't want to give a bottle) she's 5 months now and will happily take a bottle of expressed milk. My older dd didn't have a bottle until she was 3 months and point blank refused!

If you do pump I got much more first thing in the morning, usually enough for 4 top ups in one session.

Congrats on your new baby.