Jaundice

[Meowstro]

Just been discharged from hospital yesterday and although we had been in a couple of days for suspected mystery illness (that neither of us ended up having), I started to notice last night that my LO has gone a yellow colour, especially in the mouth, LO had been struggling to breastfeed but took formula OK so I've done that instead. LO is not waking for feeds so we missed one by accident last night where we'd all been asleep.

I'm now setting an alarm for feeds and put LO in the carry cot by the window in the meantime but I was told community midwife would be coming today although I haven't had a call. I'm assuming this could be a mistake as it's a Sunday but is it safe to wait another day?

I would take LO to a&e. Wouldn't wait for the midwife. They're not doctors.

Phone the postnatal ward and they'll take you back into there rather than going via a&e

Also try lots of skin to skin to encourage her to feed in the meantime

You should have a number for the maternity ward on your discharge paperwork which would give you direct access. We were sent back 2 days after getting home with ds to have jaundice assessed, it is very common.

I'd phone the postnatal ward now and ask for advice.
Jaundice in newborns can have serious consequences if it's severe and untreated.

The midwives in postnatal wards can get babies blood tested to see if jaundice is severe enough to need treatment when babies are on postnatal wards. Not sure how they check once babies are discharged, but the postnatal ward is the best place to ask.

How old is your baby? If the midwife is still visiting, I presume under 10 days.
50% of newborns are visibly jaundiced from 2-7 days of age, with a peak at day 5-6. Babies that are feeding enough to have a good urine and stool output are rarely sick. Daylight exposure is much less important than good feeding.

The community midwife has a little gadget torch thing that she can put on baby's cheat to measure the jaundice level. If she's meant to be visiting today she should do regardless of it being a Sunday but if you're concerned then call the unit and ask. All of mine had to go back into hospital for UV light treatment after being discharged

Not waking for feeds. Not feeding as well as before. Probably jaundiced. Kept in longer than usual for observation, due to concerns about possible illness. Young enough to be still under the midwives.

I'm sorry, but your baby definitely needs checking over today. They may well be fine. But they may not be. And at that age they are incredibly vulnerable. I would anticipate that the midwife would be extremely likely to one them checked over by paediatrics. That sort of story is a pretty regular one for admission.

The midwife should check for jaundice when they visit, you would norm get sent back up to the childrens/maternity unit and they can test to see if baby needs treatment or not.
Jaundice is common and norm do not need any treatment, but sometimes babys need a bit of time under the lamp or in extreme cases a blood transfusion.

I would phone postnatal ward or labour ward or maternity triage whichever one you have the number for. They will either ask you to come in or they will be able to check if your mw is visiting today.

Sounds like your baby does have some jaundice which is quite normal in newborn babies, it's just dangerous if it's a significant amount. Your baby will need a small blood test and if the result is over a certain level (the level depends on how many days old and what gestation at birth) then will require some treatment.

Thanks for the responses, really helpful. A friend told me to wait for the hv and they'll give advice but I was sure in some circumstances it could be serious. I noticed my LO wasn't even waking for a nappy change at all as I've been having to do a nappy change as a wake up call whenever a feed is due. Currently waiting in A&E upon the advice of the postnatal ward so I'll see what they say.

Glad you've spoken to postnatal ward and currently waiting to be seen. Hope all is sorted out soon

Glad you're going to get checked out. I hope all goes well

The A&E doctor confirmed jaundice which he said wasn't showing up as dangerous levels on his little device but advised to up feeds. Otherwise, he suggested admitting us both so we can establish feeding.
I kind of felt like it was a bit of a blame game as it doesn't always help jaundice as far as I was aware. Maybe it wasn't intentional but felt a bit shit when me and LO try so hard at bf (always tried before a bottle and she is a fantastic one for latching but just gives up after a little while, even the breastfeeding people were a bit when I was in hospital) and she is ace at taking a bottle when I can wake her up. Anyway, he's said it's not dangerous to wait a day to see how upping feeds goes and I can go back and be admitted if she's still the same/worse.

Feeding is the best way to treat jaundice that is under the official
Treatment levels. Bilirubin which causes jaundice is excreted via urine and stools so the better fed a baby is, the more urine and stools will be passed.

Don't feel bad, low level jaundice is actually a normal physiological process for babies and most mums struggles with feeding in the early days.

Thanks, he hadn't explained that really, just that drinking helped it. I read bf (or the need to establish it) doesn't necessarily help and can make it worse in some cases, maybe it's a myth? Upon orders I'm trying to make sure LO gets 90ml 4 hourly! We're not quite getting there, even with bottle feeding and it's just making her sick tbh but she's trying, she's only 3 days old.

My DD had jaundice and it sounds like she was similar to your DD. She wouldn't wake for feeds or nappy changes, for anything really! We lived our lives to the two hour timer set on my phone to make sure she was feeding regularly for about two weeks, she would often fall asleep on the boob very quickly after latching but stroking her cheek to encourage suckling and tickling her feet and belly kept her awake long enough to have a good length of feed, before that I was hand expressing and syringe feeding. We had to go into hospital because our midwife thought she was more jaundiced than she actually was because she is mixed race and has a golden skin tone, the test showed she didn't have severe jaundice. Just feed feed feed whether it's bottle or breast, and make sure she gets some sunlight as that helps clear jaundice too. Skin to skin will help with bf if you want to try and continue, plus baby being stripped down to a nappy keeps them awake better than a snuggly babygrow. Good luck!

When my DD had jaundice we were advised 2 hourly feeding and we had to make every effort to wake her up, strip, nappy change, tickle, blow on her....felt mean and the 2 hour cycle when feeds took up to an hour because of the sleepiness was brutal but it cleared the jaundice. Good luck, keep feeding!

90ml is quite a lot for a 3 day old! Maybe try less (70ml?) 3 hourly.

My baby who is now 7 months old developed jaundice before being discharged and was treated for 2 days before we left. He was still very yellow leaving the hospital and was only a tiny bit below treatment line at 3 weeks old. His levels had gone back up and his eyes were terrible to. Jaundice had eventually gone by 9 weeks old.

Was very stressful and he had to have bloods and urine tests to check his liver function. Was diagnosed with prolonged jaundice due to breastfeeding.

As long as your baby hasn't been treated with phototherapy then the midwives usually carry a little machine to check the levels by placing on babies skin.

Thankfully, she's drinking more. I can't say she's awake more on her own terms but she is a lot more alert when she's awake now.

@Lj8893 That is exactly what I thought! A MW told me off for giving 35ml on day 2 Definite lack of consistency. She's now taking 60-70ml 3 hourly on the most part.