Jacob's Dad

Hi All,

My wife and I just had our first child, a boy named Jacob. Jacob is 6 days old and was born a very healthy happy boy. We've run into an issue with jaundice and are getting a lot of conflicting advice....bear with me.

My wife would like to breast feed our baby. Jacob has a slightly recessed pallette from sucking on his tongue in the womb, as a result he has very little sucking ability at birth.

We worked with a lactation spe******t during our stay in the hospital (S&S, syringe, massage the pallette, special bottles, etc) twice. The hospital discharged us before Jacob was fully sucking either the bottle or breast (which has made us very angry at the hospital). The lactation spe******t told us to "make sure he gets at least 15 ml and he'll pick up the sucking soon". So, we make sure he gets 15ml to 60ml every two hours for a few days and then we find he has jaundice.

We've been getting blood tests done by our pediatrician from day 3 through day 6 (today is day 6). The pediatrician recommends to attempt breast feeding for 15 min per side and then give him "as much supplement has he wants".

The problem is, since his suction is so poor he gets tired and goes to sleep. It takes a lot of stimulation (tickle the feet, rub the jowels, cold wash cloth, etc) to get Jacob to continue sucking. Generally, he can finish 60 ml of breast milk in about 15 minutes....60 ml of Similac takes about one hour (we don't think he likes it). We're now trying Enfamil, which he seems to like and took 80 ml in about 1 hour.

Total Bilirubin is currently 16.9.

My wife and I have been killing ourselves staying up late and using the pump to get Jacob 60 ml of breast milk every two hours. We assumed this would be best for his diet and jaundice, plus he likes it much better than formula. Our pediatrician tells us we are cheating him out of sucking and that we won't be able to sustain the breast milk with pump alone (the lactation spe******t said otherwise).

What do we need to do here?
How much formula should he be taking per 2 to 3 hour feeding time?
Is there a forumla that is best for dealing with jaundice?
Will forumla cause constipation? (Jacob didn't have a BM for almost a full day on similac but the breast milk has a natural softener and helps with his BM which in turn *should* clean out the bilirubin). Then again, he's only a few days old and only recently stopped passing merconian(sp).

We're also using sunlight to help break the bilirubin down. Thanks for any help you can offer.

kerrybflies

Colostrum "first milk," helps your baby pass the meconium out, since meconium buildup affects jaundice, this is the reason everyone is telling you to get the right amount of milk into your little one every two hours. I don't know of a specific type of formula that helps or hurts jaundice but as a rule breastmilk speeds up the digestive process the best, helping to clear up the jaundice.
Stick with it, you can do it and it's awesome that you are both working so hard to establish breastfeeding. I know I was so stressed when my daughter came home with jaundice, between the sleep deprivation and the constant feedings I was so run down. The doctor told me that it was important to keep track of every feeding and diaper so I was thrilled when I found Baby Insights which I used to track everything.
Good luck with everything and hope your baby is feeling better soon!

Jacob's Dad

Thanks!

We finally had a break through yesterday. One big problem is no one tells you how much formula or breast milk intake (mL or oz) that the child should get. We got three answers...one from the OB, one from the lactation spe******t at the hospital and one from the pediatrician. The range was anywhere from 15 mL per 2hr period to 2 oz per 2 hr period.

Since Jacob is having a difficult time maintaining suction, it was very hard to hit the 2 oz mark but we assumed we were ok because we had been told 15 mL was fine.

Yesterday, my wife and I set out to see a lactation spe******t in our area that was recommended by our lamaze coach. She was great! Gave us our goals per our child's weight (7 pds = 542 mL per day). We set out to get that amount into our child utilizing some skills she taught (finger and syringe method). We also found that the Medela line of bottle nipples with the smaller head work great with Jake.

Today we had a reduction in billirubin from 15.4 to 13.2 and he was able to maintain his weight.

I wish someone had told us (as new parents) that information up front. One of the most frustrating things was being told by the pediatrician to "just give him what he wants" and yet not identify or recognize the lethargy in our son.

We're very happy he's doing well and expect a weight gain and further billirubin reduction on Friday. All of this is being done on breast milk (supplementing Enfamil where we come up short during pumping).

DRM0329

In order for the jaundice to go away the baby needs to poop. breastmilk is best, but fluid in general is important. just keep giving as much breastmilk/formula as he will take. and make sure the baby is pooping. while he is alseep you could also place him in his bassinet by the window and allow the sunlight to come in on his body. just make sure he doesnt get too hot. this also helps with jaundice. keep consulting with your lactation spe******t as well to help him achieve and maintain a good latch.