Jaundice 101

2018-08-22T16:31:36+00:00August 22nd, 2018|Categories: Fertility Blog|Tags: , , , , |

Most infants (50-70%) develop jaundice in the first weeks of life. If your baby has jaundice, he may have yellow-tinted skin or eyes. The yellow color is the result of too much bilirubin in your baby’s blood; bilirubin is a brownish – yellow color. Typically parents notice yellowing in the face and eyes in the first 2-4 days of life; the yellowing starts in the face and moves down to the toes. Bilirubin levels typically peak between 3 to 7 days after birth.

Before birth, your baby’s body uses your placenta to remove bilirubin from his blood. But during the first days of life, your baby’s liver can be slow to begin working and bilirubin can build up. We all have bilirubin in our bodies, it is a naturally occurring waste product created when our bodies replace red blood cells (the lifespan of a red blood cell is 120 days). Usually our liver filters out the bilirubin and we excrete it in our stool. If you have ever wondered where our poop gets it is color – look no further than bilirubin!

The best way to shorten the duration of jaundice, or prevent it all together, is to breastfeed your baby early and often. Breastfeeding within the first hour of life helps your baby pass the dark, sticky poop called meconium and takes out bilirubin with it. In the first hours, your baby is drinking colostrum, which is a laxative in addition to an immune system booster. Put your baby to breast often, frequent breastfeeding helps your baby pass more stool and bilirubin too.

There are 3 common types of jaundice:

1. Physiological jaundice. It is often most noticeable when the baby is 2 to 4 days old. The most common type of jaundice, it does not cause any distress and disappears without treatment by 14 days old.

2. Breastfeeding jaundice. This type often occurs in breastfed babies during the first 7 days of life. If your baby has difficulty breastfeeding or your milk comes in after day 3, your baby may develop breastfeeding jaundice.

3. Breast milk jaundice. Develops after the first 4-7 days of life, persists longer than 14 days and has no other identifiable cause. Doctors are still unsure what causes breast milk jaundice. However, evidence suggests it is related to the interaction between some of the components in breast milk and bilirubin.

If you notice a yellow tint to your newborn’s skin or eyes, talk to your baby’s doctor about the need for testing and monitoring her bilirubin level. Bilirubin levels can be tested with a blood or skin test. A very high level of bilirubin can result in a condition known as kernicterus and brain damage.

Most cases of jaundice resolve without treatment as the liver matures and filters blood more effectively; frequent breastfeeding helps the bilirubin pass through and out in your baby’s stool. More severe jaundice may require treatment with a bili-light (or phototherapy). Phototherapy is a common and highly effective method of treatment that uses light to break down bilirubin in your baby’s body. It looks like a little tanning bed; your baby will only be in a diaper and wearing protective goggles. Absorbing the special blue-spectrum light through the skin helps your baby break down bilirubin.

While most babies develop jaundice, few need treatment. The combination of frequent breastfeeding and your baby’s liver working more effectively usually take care of the problem. See your pediatrician if your baby acts more tired than usual or you have any concerns.

Jaundice Explained

2015-09-09T03:46:38+00:00September 9th, 2015|Categories: Fertility Blog|Tags: , , , , |

Most infants (50-70%) develop jaundice in the first weeks of life. If your baby has jaundice, he may have yellow-tinted skin or eyes. The yellow color is the result of too much bilirubin in your baby’s blood; bilirubin is a brownish – yellow color.

Before birth, your baby’s body uses the placenta to remove bilirubin from his blood. During the first days of life, your baby’s liver can be slow to begin working and bilirubin can build up. We all have bilirubin in our bodies, it is a naturally occurring waste product created when our bodies replace red blood cells (the lifespan of a red blood cell is 120 days). Usually, our liver filters out the bilirubin and we excrete it in our stool. If you have ever wondered where our poop gets it is color – look no further than bilirubin!

The best way to shorten the duration of jaundice, or prevent it all together, is to breastfeed your baby early and often. Breastfeeding within the first hour of life helps your baby pass the dark, sticky poop called meconium and takes out bilirubin with it. Frequent breastfeeding helps your baby pass more stool and bilirubin too.

There are 3 common types of jaundice:

1. Physiological jaundice. It is often most noticeable when the baby is 2 to 4 days old. The most common type of jaundice, it does not cause any distress and disappears without treatment by 14 days old.

2. Breastfeeding jaundice. This type often occurs in breastfed babies during the first 7 days of life. If your baby has difficulty breastfeeding or your milk comes in after day 3, your baby may develop breastfeeding jaundice.

3. Breast milk jaundice. Develops after the first 4-7 days of life, persists longer than 14 days and has no other identifiable cause. Doctors are still unsure what causes breast milk jaundice. However, evidence suggests it is related to the interaction between some of the components in breast milk and bilirubin. Breast milk jaundice seems to have a genetic component, as it runs in families.

If you notice a yellow tint to your newborn’s skin or eyes, talk to your baby’s doctor about the need for testing and monitoring her bilirubin level. A very high level of bilirubin can result in a condition known as kernicterus and brain damage.

Compiled from these references:

Bramuzzo, M., Davanzo, R. (2010). Neonatal Jaundice and Breastfeeding Reputation. J Hum Lact,; vol. 26, 4: pp. 362. Retrieved from http://jhl.sagepub.com/content/26/4/362.full.pdf+html

Deshpande, P. (2014). Breastmilk Jaundice. Medscape, retrieved from http://emedicine.medscape.com/article/973629-overview

Kaneshiro, N. (2014). Newborn Jaundice. MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/001559.htm

A rough beginning but a happy ending – the conclusion

2014-12-17T20:37:36+00:00December 17th, 2014|Categories: Fertility Blog|Tags: , , , , , , |

Lauren was born in August and the days were warm and still. I felt relatively well and especially grateful to not be pregnant anymore in this hot weather. Lauren was breastfeeding around the clock and my older boys were busy with outside activities.

The nipple pain started on day two. Lauren always had a shallow latch but I kept working with her to take more breast tissue, enough that her top and bottom lips would curl over. I tried the positioning technique I learned from Dr. Newman – pulling her belly button in close and keeping her head aligned with her little body. It seemed like a natural way to hold her; she seemed comfortable and swallowed easily. Her latch remained shallow although I tried everything – pumping before feeding, holding the breast to make it the size of her mouth and waiting for the wide open mouth before putting her to breast. Nothing helped.

The nipple pain continued and they were bloody and cracked by day 3. Each time I fed Lauren I tried to get more breast tissue into her mouth and deepen her latch, but she would always slip down, causing pain with each feeding. Making matters worse, Lauren was not emptying the breast well with her shallow latch and she would often become frustrated, crying inconsolably. Oh the early days with a newborn – it is a tough time mommies!

Near the middle of day 3 I tried breast compressions as Dr. Newman had taught in his seminar. The technique is simple and easy to master. Place the hand on the breast the baby is nursing on and gently squeeze or push down on the ducts which are located above the areola. More milk is pushed down into the baby’s mouth than by suckling alone. This helps baby get full and mom’s body gets the signal to produce more milk. A win-win situation.

Day 4 and 5 we turned a corner and things got easier. I was using breast compression at every feeding; Lauren was growing bigger and stronger. As her mouth grew she was able to take more breast tissue into her mouth and my nipple pain subsided. She was still fussy in the evening, but soon she outgrew that too.

My early days with Lauren reminded me that each baby is different. Although I had breastfed before, Lauren hadn’t. It took us almost a week to learn this new skill. I was grateful to have a toolbox of interventions to try, since nothing seemed to work in the beginning. I also had the experience of successfully breastfeeding my other kids; I believed I would eventually be successful with Lauren too. Sometimes things just get better with time and experience. When the photo at the top of this post was taken, Lauren was 7 weeks and already traveling with me to talk about Milkies. She is showing a hunger cue I got to know well – sucking on her fist.

I also give credit to Dr. Newman. He has worked with thousands of mom and baby pairs and gives practical, easy-to-follow advice that worked very well for Lauren and I and so many others.

Here is the link to his website again.