JAUNDICE IN THE HEALTHY NEWBORN
WHAT IS JAUNDICE?
After birth, excess red blood cells break down and the yellow pigment – the byproduct of this process – circulates around in the blood. While the liver ‘catches up’ with the amount of bilirubin to be processed and eliminated from the baby’s body, it can show up in yellowing of the skin and the mucous membranes of the body (for example the eyes).
IS IT NORMAL?
This phenomenon is more common than you think. In fact more than 80% of newborns appear jaundiced in the first week of life!Only 5% of babies require treatment for this condition though.
CAN IT BE BENEFICIAL?Bilirubin is an effective ANTIOXIDANT which newborns are naturally deficient at. So according to some theories, breastfeeding jaundice (NOT pathological jaundice) can actually be protective for the baby.
WHEN TO BE CONCERNED?
‘Starvation jaundice’ is present in the first few days after birth (but not before 24 hrs). Risk factors include: -sleepiness in baby-prematurity-poor positioning and latch-inadequate milk transfer. Your health care professionals will measure your baby’s bilirubin levels and decide if it grants further intervention, e.g. photo therapy (baby will be put under special lights). According to the Academy of Breastfeeding Medicine protocol (see reference below), BREASTFEEDING SHOULD NOT BE INTERRUPTED while baby is receiving treatment.
WHAT CAN YOU DO?
– WATCH THOSE NAPPIES:
Keep breastfeeding regularly, especially in the early days, while your supply is getting established. Frequent feeds are the key to effective elimination and regular poos, which will in turn clear bilirubin from baby’s body.
– BREASTFEED EXCLUSIVELY (unless medically indicated otherwise):Don’t give water! Doing so will decrease baby’s appetite for breast milk and hence delay the elimination process. It will also interfere with milk removal and can reduce your supply.
– WATCH THE SCALES:Keep an eye on weight gain. If jaundice persists for 2-3 weeks or even beyond (as long as up to 3 months), but baby is thriving and following his/her per centile line, treatment is rarely required.
– ACHIEVE THE BEST LATCH POSSIBLE:In any case, this will serve you well on your breastfeeding journey. Reach out for any help available from a skilled breastfeeding supporter, who will WATCH A FEED. This will ensure baby is comfortably and deeply attached at the breast, swallowing milk effectively and this milk transfer will ensure baby’s weight gain and your sufficient supply.
WHAT’S IN A NAPPY?
By day 3, you will see a lightening of the black-brown tarry meconium, and heading towards a greenish colour. Once your milk comes in, you should see the poos turning mustard-yellow in colour and copious in volume, at least 2-3 times a day. Alongside about 6 heavy wet nappies a day from day 6 are a good indication of sufficient milk intake.
More information can be found:
1. https://abm.memberclicks.net/…/22-jaundice-protocol…
