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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

My week-old daughter is jaundiced, and I am beginning to fear that it is from my breast milk. If I supplement with formula for one or two days can it turn her away from the breast forever?

Jaundice is fairly common in a newborn. Most of the time it is not a problem and will go away with lots of breastfeeding. It depends on how high the bilirubin level has gotten. Since your post did not mention a level, I am unsure just how high your baby's has gone. If it is over 18 or so, many physicians will prescribe a bilirubin light or blanket to help the baby's bilirubin level drop, along with frequent feedings. The problem, and we don't know why, is that when the level goes up, the baby tends to get sleepier and want to sleep more. This is at the exact time when we want Baby to eat more! So lots of waking and encouraging are important.

If you have lots of milk by this time, and if your little one will nurse 10 or more times a day, that would be great. If you can't get your baby to nurse that often, you might consider pumping your milk if she is sleepy and not nursing for long and feeding it to her with a little dropper, syringe or cup to make sure that she is very well hydrated. In this way we can avoid some of the problems that bottles promote.

Jaundice is not caused by your breast milk, and most physicians do not remove the breast milk from Baby's diet to substitute an artificial milk if there is plenty of breast milk available. Be sure your baby gets lots of your milk and is having lots of wet diapers and bowel movements. Be sure to stay in touch with your health care provider and get the bilirubin level checked often until the level drops.

If she is yellow all the way to the soles of her feet, it is probably a high level and the doctor needs to evaluate your baby. There is a very serious problem that can develop if jaundice goes to a high level. It is rare, but certainly it is important to be watchful that her level does not go high enough to cause serious problems.

Sincerely,
Ann Calandro, RNC, IBCLC"

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