High bili count?? HELP

[hillview]

DS (now 2.5 weeks old) had an increased bili count when we left the hospital so spent a night and 2 days under the lights. We were sent home. For a week after that we went in for daily blood tests and after not nursing for 24 hours his count went down (it never got higher then 19). Now a week later DS his count is up 2 to 17.5 and we have to go see a GI doc on Monday.

Am getting quite worried and wondering if anyone has BTDT.
TIA!
/hillary

[caleymama]

I have no advice for you, but wanted to congratulate you on your new DS! I hope you get some answers.

[Java]

You need to nurse as much as possible! Day and night - you are an all-you-can-eat diner.

DD's levels were 20 at 1 week old and she was almost hospitalized. The fact that she nursed so well was what kept her at home with me. We did the bili blankets for a week and the boob was offered every 2 hours. I would wake her to nurse every 2 hours during the day and every 3-4 hours at night.

At first we didn't see any change. Then on day 3 the levels starting to drop and finally after 5 days it went down to 13.

My ped told me to nurse, nurse, and nurse some more to get rid of the excess bilirubin. Sit by the window when nursing, go for a walk in just a onesie, expose as much skin as possible to sunlight (safely of course).

Good luck!

[maestramommy]

Arywn's highest was 16. At that time she was already home, and we didn't have a bili blanket. I was told to feed her as much as possible, and get her in the sun. Wouldn't you know it coincided with the cloudiest days in June? But I did nurse her and even offered her a bottle of pumped milk after each nursing session. Every 2 hours. I know in some cases they "may" counsel you to offer formula, as a "quicker" way to get the bilirubin out. We never went that route, but I know some who did and I guess it worked for them.

[neeter]

After attempting to nurse all the time, our doctor suggested using formula for 3 days. It totally worked, and I just pumped and froze the milk.

[Tondi G]

This is what my neighbor did as her son was totally dehydrated and wouldn't even wake up long enough to get in a decent nursing session. She pumped and froze the milk for I think 2 days and gave formula. Then the 3rd day she started mixing the formula with some pumped milk and then went right back to nursing exclusively. It worked fast for her DS and he was home and healthy in no time!

My DS was pretty jaundiced (he was quite yellow) but my ped said since he was nursing every 2 hours around the clock to just keep it up and get him in some sunlight. He said it is more of a worry if the baby was super sleepy and wasn't nursing enough. He pinked up within a week I think!

Good luck

~Tondi
Mommy to Mason 7/01 and Aidan 5/05

[c914]

Sorry to hear you are going through this.

Are you doing home phototherapy? Or does the Ped think its something a little more complex than newborn jaundice? At 2 weeks of age, I would guess the numbers should have peaked by now.

My 2 DS's required phototherapy - DS#1 (poor nurser) had inpatient and with DS#2(good eater from the get-go) we did the bilibed, and both were term gestations. It took about 3-4 weeks for it to finally wash out.

Hope things clear up soon!
Carla

[hillview]

Thanks all. Yes DS should have peaked by now. He has gained 10 oz in 7 days so is nursing a lot and quite well. We did a formula trial for 24 hrs which did bring it down but then we went back up so doc has us going to a GI specialist. Hope it isn't anything more complicated but will find out on Monday I hope.
Thanks again all!
/hillary

[SAHMIL]

I wouldn't worry. My DS, when he was 9 days old, had a count of like 15. The pediatrician said that the jaundice will get out on its own and that when you look at the age and the count it's not that big of a deal. I was told at 2 weeks of age to feed on demand. In the meantime, for about an hour or so everyday, I put him in the bouncy seat dressed down to the diaper and put him in front of the window with the bouncy seat facing away from the window. (towards the inside of the house and his head was towards the window.) It was like he got a sunbathing session. He slept for that hour or so, and my mom watched him and I got a shower.

[Bens Momma]

We went through something similar with DS #2. As I remember the ped showed us a chart where the bili count that they can tolerate CAN be higher the older they get. In other words, a count of 15 or 16 is much more dangerous in a baby that's 1-2 days old than it is for one that's 6-7 days old. That said, it should be leveling out for your DS so I would think that they would want to keep testing at least once or twice more to see that it isn't continueing to climb. I agree with PPs, try to get him outside as much as you can and keep him well hydrated as peeing the bili out is they fastest/best way for him to get rid of it. For what it's worth, our DS spent an extra week in the hospital under photo therapy and when he was finally released his bili level climbed slightly the following 2 days but then leveled out. Even though we were concerned and sure he should've still been having daily blood tests, the pediatric team saw that it was starting to slow and that it was at levels that were fine for the days old he was at that point. They assured us that it would start dropping and it did! He's almost 2 yrs old and everything turned out great!!

Good Luck!
Momma to 2 DS

[american_mama]

My DD2 had high bilirubin due to ABO incompatability. I think her highest was 17. She was in a teaching hospital that had a reputation for aggressive treatment, and I suspect what they considered a problem would have been handled much more conservatively elsewhere. She too spent a night and two days under lights in the newborn unit, and I too suspended breastfeeding for 24 hours, although I later learned this is debateable advice. I was and remain a little confused about jaundice and its variations, and wonder if the medical community is a little of two minds about it as well. You may notice that there are some contradictions in the links I have posted below.

Here's a short article by a pediatrician and breastfeeding expert. He says jaundice isn't a problem unless it's really high and/or accompanied by other clinical problems.
http://www.drjaygordon.com/development/pediatricks/jaundice.asp

And another from a Canadian pediatrician and breastfeeding expert saying the same thing
http://www.bflrc.com/newman/breastfeeding/jaundice.htm

Genereal overview of juandice:
http://www.breastfeedingbasics.com/html/jaundice.shtml

You might also want to research "breastmilk jaundice", which usually lasts longer than other jaundice. I never could quite understand what it was - seemed poorly defined to me - but if your child's jaundice lingers and especially if you are seeing specialists who probably aren't super familiar with breastfeeding, it's going to take a lot of education on your part to ask the right questions and not believe breastfeeding should be abandoned.

Another article about breastmilk jaundice which cites some articles by Dr. Newman:
http://parenting.ivillage.com/baby/bbreastfeed/0,,7fzp,00.html
A brief Ntl. Library of Medicine summary:
http://www.nlm.nih.gov/medlineplus/ency/article/000995.htm

[egoldber]

"As I remember the ped showed us a chart where the bili count that they can tolerate CAN be higher the older they get. "

This is what we were told by the neonatologists when Amy was in the NICU as well. She had a level of 15, which was more concerning to them because she was 34 weeks and 3 days old. At day 12 she still had a level of 15 but they were less concerned because she was older.