Feeding methods such as a spoon, cup, eyedropper, syringe or an at-breast supplementer, in preference to the bottle, can facilitate transition to full breastfeeding.
Phototherapy is the most frequently used treatment when bilirubin exceeds thresholds. The baby remains under the lights continuously for a day or two, although parents may remove the baby from the lights for feedings.
One of the problems with phototherapy is that it interferes with mother and baby being together and interacting freely in the first days of life. In hospital, it may be possible for the phototherapy unit to be set up in your room, so that you can talk to, touch and breastfeed your baby frequently. If the baby is hospitalized but you are not, you can stay with your baby in the nursery. If treatment is needed after release from hospital, your doctor might order a home phototherapy unit.
Putting the baby in indirect or direct sunlight as an alternative to phototherapy is no longer recommended to treat jaundice. Indirect sunlight is not reliable and direct sunlight can cause a dangerous increase in body temperature and sunburn. Physicians used to suggest routinely substituting formula for hours or supplementing breastfeeding to bring down bilirubin levels. This course of action is no longer routine but may be suggested when phototherapy is not readily available or deemed unduly expensive.
It may be used, often in conjunction with phototherapy, when high bilirubin levels must be reduced urgently. Interrupting breastfeeding can lead to early weaning and deprive the baby of the many benefits of breastfeeding.
If supplementation is necessary, pumping is critical for the mother to build up and maintain her milk supply. A baby whose tummy is filled with water or sugar water will nurse less often and thus is more likely to have problems with jaundice. The American Academy of Pediatrics suggests that pediatricians discuss several treatment options with parents. Here are some questions to consider:. If a doctor suggests that you stop breastfeeding and give your baby formula, ask about using phototherapy to treat the jaundice while you continue to breastfeed.
In most babies, jaundice is short-lived and harmless. For sure, there may be times when it is necessary to treat the jaundice, but in these situations, parents and health professionals should remember that frequent breastfeeding in the first days of life helps ensure successful breastfeeding in the weeks and months to come.
The goal is a healthy baby who continues to breastfeed. Babies who are latched-on well get more milk from the breast. Baby should be facing mother and pulled in close to her body. The baby opens her mouth wide as she goes onto the breast and takes a large mouthful of breast tissue. If baby is not latched-on well, take the baby off the breast and try again. Check for effective sucking.
The baby moves her jaw, not just her lips, as she sucks. After the initial let-down, baby will swallow after every one or two sucks. This active swallowing should continue for ten to twenty minutes per breast. Keep baby interested. Encourage baby to breastfeed longer by using breast compression when her sucking slows or stops.
Hold the breast between your thumb and your other four fingers, close to the chest wall. Bring the thumb and fingers together, firmly compressing the breast, but not so hard that it hurts. Breast milk jaundice Breast Milk Jaundice is jaundice that persists after physiologic jaundice subsides. Breastfeeding jaundice Breastfeeding jaundice is caused when the baby does not get enough milk.
What is the treatment? If bilirubin levels are below 20 milligrams, the following treatments are often used for breast milk jaundice and breastfeeding jaundice in the full term, healthy infant: Increase feedings to times a day. The best way to decrease bilirubin levels it to help remove it. Increasing feedings will result in increased bowel movements, which will excrete the bilirubin.
The improper latch can directly affect how much milk a baby is receiving. The mom would also want to pump during this time in order to not interrupt the production of her milk. Using a lactation aid to deliver expressed breast milk or a mixture of breast milk and formula is the best way to not interrupt the breastfeeding relationship. Rarely is the interruption of breastfeeding an effective treatment for jaundice in a breastfed baby.
This can usually drop bilirubin levels dramatically. The mom can then resume breastfeeding after the 24 hour period. Using a lactation aid to deliver supplementation and pumping during this 24 hour period would be the best way to avoid any problems in the breastfeeding relationship. If phototherapy is recommended usually only if bilirubin levels reach over milligrams , talk with your health care provider about using fiber optic blankets.
These can be taken home and allow the breastfeeding relationship to continue with no interruptions. Increased feedings and the use of the bilirubin lights should effectively lower the bilirubin levels. Treatments not recommended for decreasing jaundice in the breastfeeding infant: Supplementing with sugar water—In fact, this can worsen jaundice by interfering with breast milk intake and breast milk production. It can also delay the reduction of bilirubin levels.
Frequent and efficient feedings of breast milk are the best way to decrease jaundice. How can jaundice be prevented? Initiate the breastfeeding relationship as soon as possible after birth.
Studies show that the breastfeeding relationship has fewer challenges and a higher rate of success when it is initiated in the first hours after birth. Work with a lactation consultant to make sure that a proper latch is achieved and the baby is taking in adequate amounts of milk. Feed the baby frequently in the first days and weeks of life. If the baby is sleepy, work to keep them awake so that they get full feedings.
Breast milk jaundice may run in families. It occurs just as often in males and females and affects about a third of all newborns who get only their mother's milk. Are your newborn baby's skin or eyes yellow? Is she extremely tired and doesn't want to eat? Your baby may have jaundice. Newborn jaundice happens when your baby has high levels of bilirubin in her blood. This yellow pigment is created in the body during the normal recycling of old red blood cells.
The liver helps break bilirubin down so it can be removed from the body in the stool. Before a baby is born, the placenta removes the bilirubin from your baby so it can be processed by your liver. Right after birth, the baby's own liver takes over the job, but it can take time.
Most babies have some jaundice. It usually appears between the second and third day after birth. Often babies get a screening test in the first 24 hours of life to predict if they are likely to develop jaundice. Your baby's doctor will also watch for signs of jaundice at the hospital, and during follow-up visits after your baby goes home. If your baby seems to have jaundice, the doctor will test the bilirubin levels in her blood. So, how do you treat newborn jaundice?
Jaundice usually goes away on its own, so treatment is usually not necessary. If your baby's bilirubin level is too high or rising too quickly, however, she may need treatment. You'll need to keep the baby well hydrated with breast milk or formula. Feeding up to 12 times a day will encourage frequent bowel movements, which help to remove the bilirubin. If your baby needs treatment in the hospital, she may be placed under special blue lights that help break down bilirubin in the baby's skin.
This treatment is called phototherapy. If your baby's bilirubin level isn't rising too quickly, you can also do phototherapy at home with a fiberoptic blanket that contains tiny bright lights. For most babies, it takes about a week or two for jaundice to go away. Very high levels of bilirubin, however, can damage a baby's brain.
The good news is that this condition, called kernicterus, is almost always diagnosed long before bilirubin levels become high enough to cause damage, and phototherapy treatment will usually make it go away.
In some cases, a blood test to check for glucosephosphate dehydrogenase G6PD may be done. G6PD is a protein that helps red blood cells work properly. Another test that may be considered consists of stopping breastfeeding and giving formula for 12 to 24 hours. This is done to see if the bilirubin level goes down. This test is not always necessary. Often, the bilirubin level is normal for the baby's age. Newborns normally have higher levels than older children and adults.
In this case, no treatment is needed, other than close follow-up. You can prevent the kind of jaundice that is caused by too little breastfeeding by making sure your baby is getting enough milk.
0コメント