When I was expecting Mercy, my third child, I had planned on having a homebirth. However, we ended up transferring to a local hospital “for a little pit” (pitocin) to augment my wimpy labor.
After she was born, I was VERY tired and not interested in driving home. Looking back, I probably should have because my postpartum hospital stay was obnoxious, but I did learn a few things in the process.
Here’s a few baby friendly jaundice treatment tips I learned during my 2 day postpartum hospital stay that are simple and can be used immediately.
Baby Friendly Jaundice Treatment Tips
Around 24 hours after Mercy was born, the newborn nurses screened her bilirubin levels. They did this by using a wand, similar to a thermometer that touches the skin on the forehead. Her levels came back elevated which prompted a heel stick.
After the heel stick they sent her bloodwork to a lab, and then Mercy and I went back to our room and tried to get some rest. Ha.
Baby (Not) Friendly Jaundice Treatment
Next, at an ungodly hour a nurse came into my room, flipped on the lights told me that
a) we needed to do phototherapy and
b) I also needed to start supplementing with formula
because the heel stick levels were high.
I laughed. I literally laughed at her. (Who does that??? Who flippantly says “you need to supplement with formula” without having a conversation??)
I told her we could start phototheraphy but that there was no way I was supplementing with formula. What a joke.
I undressed Mercy, put her protective eye-wear on, placed her in the bassinet and wheeled the light machine over her. I was no longer able to hold my baby, except when breastfeeding. What a nightmare.
In the morning a kind, intelligent nurse came in. I was pissed (not at her, the situation) and she knew it. At this point I was extremely defensive, aggravated and generally suspicious of the entire medical staff at the hospital.
She quickly showed me the chart below and helped me to understand what was going on. Mercy’s bilirubin levels were indeed higher than they would like to see at the 24 hour mark.
She talked to me like I was an intelligent human being. She answered my questions. She explained things and helped me to understand what conversations were likely coming my way.
If you’re unfamiliar with jaundice, here’s a little snippet from the Sears’ website.
Jaundice (also known as hyperbilirubinemia) is the cause of the yellow tinge that colors the skin and eyeballs of newborn infants, especially in the first week or two. Jaundice happens because babies are born with more red blood cells than they need. When the liver breaks down these excess cells it produces a yellow pigment called bilirubin. Because the newborn’s immature liver can’t dispose of bilirubin quickly, the excess yellow pigment is deposited in the eyeballs and skin of the newborn.
This kind of a jaundice is called physiologic jaundice, because it is part of a normal body process. Once the newborn’s bilirubin-disposal system matures and the excess red blood cells diminish, the jaundice subsides – usually within a week or two – and causes baby no harm. Jaundice is more common in premature infants, who are less able to cope with excess bilirubin.
In some situations, such as an incompatibility of blood types between mother and baby, jaundice may be the result of problems that go beyond the normal breakdown of excess red blood cells. In rare instances, the bilirubin levels can rise high enough to damage baby’s brain. For this reason, if the healthcare provider suspects that something more than normal physiologic jaundice is the cause of baby’s yellow color, bilirubin levels will be monitored more closely, using blood samples. If the bilirubin level gets too high, your doctor may try to lower the bilirubin level using phototherapy, special lights which dissolve the extra bilirubin in the skin, allowing it to be excreted in the urine.
Thank goodness for nurses like her because I was about to go all ape-sh*t on EVERYBODY for messing with me and my baby. (Lots of curse words were flying through my head.)
The following are extremely practical baby friendly jaundice treatment tips and what happened next in our newborn jaundice journey
Advocate for Your Children
The first baby friendly jaundice treatment tip is to advocate for your children.
I’m not one to receive medical intervention lightly. If I am going submit to a medical procedure I need to know WHY we need to intervene and HOW we will be intervening. I need to be sure that the risks or the consequences of the medical treatment are less than the benefits of the procedure. I need to trust my care provider.
This holds even truer for my children.
One thing I teach my childbirth class students is that the parents are their baby’s advocate. Nobody else will speak up for them like a parent will and should (and someone needs to speak for them as they have no voice). It is their duty to ask questions and to advocate what’s best for their children.
It is the parent’s job to ask questions and participate in the decision making process, especially when it comes to medical care. It is negligent to to passively agree to whatever the medical professionals suggest because “they are the experts”.
YOU are the expert of your child. THEY are the expert in their field. By collaborating and coming together we can make decisions that are best for our children.
To help parents learn to ask questions, make decisions and work with various care providers I teach the B.R.A.I.N. acronym. I teach the acronym in the context of childbirth, but the lesson can be applied to other aspects of life such as making medical decisions for our children.
TIP: Study the B.R.A.I.N. acronym and role play with someone for practice. It’s difficult to use the acronym at 3 am when abruptly woken up, so the more practice the better.
Go with Baby
The second baby friendly jaundice treatment tip is to always go with baby so that at no point will baby be separated from a parent.
I realize that this might not always be possible, but in general there should be no reason to separate baby from parent. It is a BIG DEAL to separate a baby from its parent.
When I was woken up in the middle of the night to test Mercy’s bilirubin levels, the nurses actually requested to take her to go see the doctor. Without me.
I said no and requested the doctor come see me. They asked him and he said no, but then invited me back to the nursery.
Sure. I just gave birth, but let’s all take a trip. (I had them wheel me in a wheelchair because walking was too exhausting.)
When I arrived in the newborn nursery I saw that Mercy wasn’t their only patient. But Mercy was the only patient that had a parent accompaniment. How sad.
The medical staff was being attentive to the babies, but let’s just say said babies weren’t exactly happy about their situation. I was sad that the mom wasn’t there to comfort her baby.
In the picture below Mercy was receiving her hearing screen. We were in the baby nursery again. Guess who took the picture? Her mother. 😉
TIP: Many hospitals do not have a newborn nursery and do most tests and procedures in the mother’s hospital room. If you find yourself in an antiquated hospital like mine, always go with baby. There should be no reason a parent can not accompany baby.
Use Formula as a Last Resort
The third baby friendly jaundice treatment tip is to use formula as a last resort.
Formula is used for treatment of jaundice because it effectively pushes excess bilirubin out of the baby’s body via urine and bowel movements.
However, using formula is extremely shortsighted and compromises baby’s breastfeeding relationship with the mother and therefore their health and well-being.
Compared to formula feeding, there is a greater learning curve with breastfeeding which can result in a baby not transferring milk very well.
I propose, that instead of jumping to formula, we use lactation consultants to help moms with a proper latch, hand expression, and other techniques to increase the overall transfer of milk.
TIP: After each regular (breast)feeding, try pumping colostrum and then spoon/cup feed what was pumped. This will appease care providers because pumped milk is measurable, like formula. Doctors want to be able to quantify a baby’s feedings. (I didn’t do this, but is a good compromise if need be.)
TIP: A baby doesn’t need much! On day 1 a baby’s stomach is the size of a cherry and a walnut on day three.
TIP: Feed baby on cue and often. Skin-to-skin will facilitate this.
I realize that some babies may need formula to beat jaundice, but formula should be used as a last resort so as to protect the breastfeeding relationship. My newborn’s doctor was way out of line to suggest formula as a first line of defense against jaundice.
I confidently dismissed the request to use formula because my latch was great, Mercy was peeing and pooping, and I could HEAR her swallowing colostrum. I knew we were OK.
The final baby friendly jaundice treatment tip is to continue to do skin-to-skin contact with baby despite the phototherapy lights. Let me explain…
Later that morning my husband arrived (I sent him home the previous night to sleep in his own bed) and was horrified to find Mercy in the isolette, alone, upset and cold since she was only wearing a diaper.
As a new, sleep deprived mom I wasn’t thinking clearly, but my husband sure was.
He flipped off the air conditioning in the room, put Mercy on my chest and brought the phototheraphy lights over to us.
He didn’t ask permission, he just did it. I’m so thankful!
Have you ever undressed and therefore chilled a newborn? What do they do? Cry.
Have you ever set a newborn down on their back unswaddled? What do they do? Cry.
The traditional jaundice treatment does not take into consideration the well-being of the infant, other than helping rid their bodies of bilirubin. By continuing phototherapy while doing skin-to-skin we were able to do both and address our needs as a whole. A win-win!
We even received visitors while under the lights. It was quite the conversation starter.
Mercy was so content now that she was back with me.
By continuing to do skin-to-skin while under the phototheraphy lights we were able to better regulate her temperature, Mercy was happy, our breastfeeding relationship was protected and Mercy was able to receive the benefits of being under the lights.
Baby Friendly Jaundice Treatment Tips
In conclusion, if a baby needs treatment for jaundice, baby-friendly treatment options should be executed if at all possible. As a parent you need to remember to…
- Advocate for Your Children
- Go with Baby
- Use Formula as a Last Resort and
- Continue Skin-to-Skin
When working with moms postpartum, I share the above advice if I see them in the same circumstance. But how handy would this information be BEFORE childbirth? Please share on social media and let parents know their options.