Jaundice, a slight yellow coloration to the eyes and skin, develops in the first day??and weeks after birth in about 15% of babies; mostly breastfed babies,?leading to the unfortunate term, “breastmilk jaundice.” This symptom results?from higher than normal levels of bilirubin in the blood. Bilirubin is a product of red blood cell breakdown. Babies are born with more red blood cells?than they will keep. These help provide extra iron stores. Because excessively?high levels of bilirubin are known to cause brain damage (higher than the levels most often seen in jaundiced newborns), doctors have long been?heavy-handed in treating this common occurrence. The problem is?that?their interventions jeopardize optimal breastfeeding?the one best treatment for jaundice and prevention of serious consequences.
One “treatment” doctors use is the provision of formula bottles for a day or two. Because of its unabsorbable fats and other excess ingredients, formula causes greater amounts of stool loss. This speeds up the elimination of biliru?bin through the stools. Of course, the free iron in formula allows challenging bacteria to develop in the newborn’s intestinal environment, getting baby off to an unhealthy start. This unhealthy bacteria also breaks down bilirubin well. Exclusively breastmilk-fed flora allows the body to re-uptake some of the bilirubin, keeping blood levels higher. But, formula feeding at this point greatly jeopardizes the successful establishment of full breastfeeding. Typical poor breastfeeding advice given to new mothers, of scheduled feedings every 3?to 4 hours, slows initial stooling and increases the number of babies showing jaundice to begin with.
Another treatment for jaundice is phototherapy, where the infant is placed in an incubator under special blue phototherapy lights. Blue light?causes the skin to rapidly breakdown bilirubin. However, a baby in a plastic bassinet is not snuggled up next to mother establishing breastfeeding, creating bonding hormones, and keeping stress hormones low. A third treatment effort for less prominent jaundice is giving bottles of sugar water. This too reduces the amount of breastmilk received and slows the establishment of a good milk supply. This practice has been shown to often make jaundice worse. A few babies are given drugs to lower bilirubin.
It doesn’t make sense that around 15% of naturally fed babies would develop some kind of harmful condition that requires artificial baby milk, unhealthy flora establishment, and separation from mother. Well, it turns out that bilirubin is about the strongest antioxidant available to the human body and no harm has been shown?from these commonly high bilirubin levels when not extreme. Rare, exceptionally high levels typically signal some kind of liver disorder, or very poor feeding, and do need immediate attention.
While this beneficial potential of bilirubin was reported as early as 1987,?and reiterated by other scientists over the next decades, this information has been ignored medically. Commonly elevated bilirubin is known not to be harmful and the science shows that it’s actually very protective. Bilirubin has been shown to prevent retinopathy of prematurity,?a common overgrowth of blood vessels in the eyes of preemies that threatens vision. Premature infants are exposed to many threatening oxidation exposures and the anti-oxidation from bilirubin could be very health protecting. It’s also been shown to be neuroprotective, preventing brain damage.?This strong antioxidant can offer many immune-providing benefits as well.
By design, there is little breastmilk available to just-born infants. The breasts provide colostrum in the first days after birth with powerful immune protective, digestion maturing, and stool clearing factors. New mothers should have baby at breast at least every 2 hours to provide regular amounts of colostrum, get the stools moving, and program the breasts to create milk. With?this proper stimulus, full milk usually comes in within 2 to 4 days. In the absence of a liver disorder, good feeding should keep jaundice appearance low or absent.
When a baby does exhibit much jaundice, watchful monitoring of biliru?bin is all that should be needed medically. Blood does not need to be drawn oftenn as there is a mechanism available to measure bilirubin right through the skin. Slightly brown urine may signify a problem. (Salmon-colored urine is a common finding that might signal a little dehydration.) A consult with a non-hospital-associated lactation specialist can assure that the infant has a good?latch and that feeding is going well. Jaundiced babies (and those medicated during birth) may be extra sleepy and need to be awakened to nurse. If doctors want bilirubin levels to be lowered more quickly, there’s a wonderful natural resource that’s often available, the sun. It can be summer or winter as blue light is part of sunlight year-round. Of course, sunburn in the peak of?summer and chilling in the cold of winter provide challenges, but actually, blue light goes right through the window (all the colors combine to create the white light we see coming in the window), while very little UV light?does. One can warm up the room, strip down the baby, and nurse in a sunny window. For more extreme needs, there is a phototherapy blanket that can be used at home while the infant snuggles and nurses. It works as well as the?phototherapy?in the hospital.
Text copyright ? THE BABY BOND by Dr. Linda Folden Palmer