Breastfeeding Advice: Jaundice Newborn 2-Week Early Baby

My heart goes out to you and I wish I was there to help out! Jaundice is very scary. My youngest was born at 36 weeks and also had jaundice. I don't know if the doctor told you but jaundice is caused because all of the systems of the body are not working correctly. Very common for a baby born early. The most important thing that you can do is get the baby to eat. The little baby is not pooping because she is not eating. Seems like a vicious cycle. If the baby likes a rubber nipple better then just feed her from a bottle filled with breastmilk. Most drugstores carry newborn nipples which are very small. This might help. Breastfeeding is supply and demand. The more the baby eats, the more milk is made. The more you pump, the more is made. The hard knots are from not emptying out the milk completely. Keep pumping and try to get some relief. My little boy was born in Feb. so getting sunlight on his naked body was not an option for us but we eventually got a jaundice bed. It helped a lot but broke my heart everytime I used it. Don't stress!! Stress will take the milk production down. I usually waited for the baby to cry before I fed him. This way everyone was more successful. Good luck and if you need more help just send a message.

For the jaundice, all 4 of mine had it. one had the billi blanket, one had the bed, one went away on its own and my youngest, who is now 3mo The doc said sunlight and a fleet pedia-lax two times a day for 3 days and it cleared right up. He told me to feed on demand and dont supplement. I hope that will help you too.

Okay, first thing, take a deep breath... You are doing fine! Breastfeeding doesn't always come naturally, and even the most experienced and prepared moms have to work at it. You sound like you have done a lot of reading on the topic. If you haven't already, visit the La Leche League website, there is a ton of helpful information there for you, as well as resources for some hands on help. Also call your hospital, pediatrician's office and your OB's office and ask if they offer help from a lactation consultant. My physician's group had one on staff that was able to do a home visit for free, I'm sure there may be something similar in your area.

My son had jaundice, and had to be under the bili-lights for 2 days. I know what you are going through. I was determined to exclusively breastfeed him, and declined giving him formula while in the hospital. Luckily, our baby nurse was understanding and suggested I pump and leave it in the nursery for "snacks" in between feedings. It is important to feed often, because the only way for the bilirubin to exit the system is to poop it out. But, my son did the exact same thing as yours and fell asleep at the boob all the time. She's brand new, and brand new babies sleep ALL the time. Keep trying to get her to eat every 2 hours. I know it seems like that's all you do, but that's normal. It will get easier. Use some of your pumped milk in a bottle and have Daddy feed her sometimes too.

You can help control the dripping a little by using nursing pads. I used to get soaked too if I wasn't wearing one. They're super easy to use, and you can get cotton reusable ones if you don't want to keep buying the disposables. Just slip them inside your nursing bra and they'll absorb all that milk that's dripping out. Another option is to pump one breast while you feed from the other. I never did this, so I'm not sure of the logistics, but a friend of mine did so I know it's possible.

You will never be "empty," your body makes milk continuously. It sounds like you are making a lot of milk right now, which makes it hard especially with your baby falling asleep so much. Keep doing what you are doing, try hand expressing some milk in the hot shower. It will take some time for your body to regulate and make the right amount of milk. Pumping can help alleviate the engorgement, but it won't cure it. What I did was to feed from only one breast per feeding, and alternate with each feeding. Your body needs to get engorged to get the message that it's making too much milk. I've heard that cold cabbage leaves can help with this, although I've never tried it.

Try not to time how long you're feeding sessions last. Just take the cues from your baby. She'll latch off when she's done. You can tell the difference between feeding and nursing for comfort by listening for her swallows. When she's feeding you'll probably hear little squeaks, which means she's swallowing. Her sucking will also be rhythmic. After awhile, she may slow down, stop and start, and you'll hear her breathing more than you hear her swallowing. That's nursing for comfort. It's not such a bad thing, but if you don't want her to do that just gently get her to latch off. She's probably sleeping at that point anyhow.

One more note on pumping, don't over do it. My consultant had told me to do it at regular times, like early in the morning when I'm more full from the night. Try to initiate let down before you start, and don't pump for more than 10 or 15 min. Don't use how much you pump as an indicator of how much you make or how much your daughter drinks, because it is NOT the same. Your baby is the most efficient pump there is.

With the jaundice, keep an eye on her. Note how many wet and poopy diapers she is having. If you are concerned about her intake, and the status of her jaundice, take her back to the doctor for another test.

Take another deep breath... Relax. If you can manage it, get out of the house for an hour without the baby. It will help you to feel human again, and recharge your confidence. You are a great mama! Good luck to you and congratulations on your baby girl!!

FIrst off, you are not alone - BF is hard work at first. I remember the feelings of shear panic as my baby got increasingly yellow and things were not working. I am nine months preggo with number 2 and way more worried about the breastfeeding than the birth itself!!

Secondly, I would find your local La Leche League leader. They are free and can give you hands on feedback and help that us online mamas can't provide. You should be able to find them through a google search. Many of them are certified lactation consultants as well.

Third, if you want breast feeding success, NO MORE BOTTLES!!!! Any lactation consulatant will tell you to never introduce bottles until your breastfeeding is established (so you can use them eventually, but plan on no bottles or passifiers for the first 5-6 weeks of life)

I would also consider attempting to feed right when your baby wakes, and will have the most energy. I went through similar issues with my daughter and it turned out we were having latch issues. (I'm not saying your are, but that is where the hands on help comes in!). The LLL leader I worked with taught me how to cup feed my infant, and I could give her 1/2 oz of expressed breastmilk prior to working on breast feeding. This gave her energy to stay awake for the feeding, without teaching her to bottle feed.

Until we got the hang of things, I woke my daughter up every 2 hours to feed her, because I knew she was not getting enough. Once we got the hang of it, I let her sleep and she woke me up when she was hungry.

If baby is not emptying you, pumping will help reduce engorgement, keep your breasts healthy and your milk supply up until baby gets the hang of things. I would not pump for more than 20 minutes at a time. 10 to 15 minutes every 3 hours should do the trick pumping-wise.

Good luck Mama!!! You can do it!!!!!

All four of my babies had jaundice. If her levels are that high - did they give you the billi lights or blanket? UV light helps babies break down billirubin. If they didn't give you a special light to keep the baby under -- put her in the window in the sun in just a diaper (Make sure its warm and toasty in your house) when she naps. As much natural sunlight as you can will help speed up the breakdown. I never stopped nursing, how frustrating that the pedi is asking you to. Was her weight gain low - something to indicate she needed more food? And why wouldn't he/she tell you to nurse AND give formula? Very strange.

Do you not have insurance? My private insurance covered the light bed and a blanket with lights... I kept it on my kids while nursing. Could you call the doctor and ask for a "Billi Blanket" or "Billi bed" (said like Billy) our hospital had it delivered through the home health service.. and they picked it up when my kids were done. Like I said, all four had jaundice so we've become old pros at this. If they won't -- Sunlight, sunlight, sunlight. :)

Problem 1 - Her falling asleep IS the jaundice. It's not your fault. Keep doing what you're doing. I would give my son a bath - which always got him worked up, or change his diaper.. while he's nursing I rub the inside of his palm.

Problem 2 - Dripping is great! It means your body is responding to baby and you're loaded with milk. Wear a nursing bra and put a pad in the cup. They have washable reusable pads or disposable ones. They are usually kept near the bottles in grocery stores and walmart. The excess leaking will stop usually, but the pads to protect your clothes are a good idea.

Problem 3 - At the beginning some women are lucky enough to overproduce. Pump off some milk before she nurses. Have her drain you, if she still wants more you could give her what you pumped in a bottle. Or you can pump after she nurses and freeze the extra milk you get. Either way. My 4th child is 4 weeks right now and I have those hard nodules. Sometimes if I massage them when he's nursing milk shoots out his nose because I have so much. :) This too will even out as your body gets used to the demand.

Problem 4 -- Every single breastfeeding Mom will have a different answer for this. I nurse on demand, anytime baby wants it for as long as the want until they stop suckling. I give breaks every 10 minutes for burping and cuddling... until baby has had his fill. I don't worry about when baby last fed or how long it has been, I don't set an alarm. BUT with your child being jaundiced you do want to watch the feedings and offer feedings more often. Since the jaundice causes lethargy. Once the jaundice clears up you can decide if you want to nurse on demand or keep a schedule. As to pumping -- usually when you pump you won't get nearly as much as baby gets. Babies are milk draining machies - our bodies respond hormonally to their stimulation and let down the milk (hence your dripping), it isn't nearly as common for Moms to produce like that for a pump. Pump for 10-15 each side and give your breasts a break. Get some milk storage bags and freeze your extra milk -- write the date on each bag. Then you will have some milk if needed. Always good to have some backup milk.

Hang in there Mom. You're doing fantastic!

Oh my goodness, yes, I've been there! I know it's stressful! I hope I can help answer your questions, and if you have any others, feel free to send me a private message.

Call your doctor to see if you can go back to breastfeeding. Breast-milk does help to clear out jaundice, but formula clears jaundice faster. Most likely, your doctor told you to stop breastfeeding so that your baby wouldn't fill up on breast-milk. However, I personally don't like this advice. I think you should have been able to feed breast milk at least every other feeding, and I think you might consider getting a second opinion.

Problem #1: This is most likely in part because of the jaundice. Most babies fall asleep during nursing at some point, but jaundiced babies sleep much, much more than nonjaundiced babies. In this case, you may have to be cruel to be kind. Strip your baby down to her diaper, grab a cold, wet washcloth, and when she falls asleep, set her down (so that she's not in your arms) and then wipe her all over with the washcloth. Let her wake up and get a bit mad and then try to feed her again. If she will eat while sleeping, even better.

Problem #2: Go to Amazon.com and purchase a Milkies Milk Saver. This is a product that collects milk from the breast that is not in use, which you can then freeze or feed to your child later. Breast milk can be kept for 4-6 months when frozen, so even if you don't need extra milk now, you may eventually! It's a really great product that I had never heard of the first time I was nursing, so I just used a towel to soak up the extra milk. But collecting it for later use makes me feel so much better!

Problem #3: These are clogged milk ducts. This is another time when a pump would be very handy! After the baby has finished eating, pump out the remaining milk. In the meantime, to treat the milk ducts, take a hot shower and massage the lumps when in the shower. Also, put a warm compress on your breasts before nursing and turn the baby's chin into the lumps. If this does not work, if the lumps turn the skin red, or if you get a fever, call the doctor for an antibiotic.

Problem #4: When you pump, do you get the same amount in milk that you are feeding in formula? If yes, you're doing fine (being engorged in the beginning is normal). If you're getting more than she needs to eat, I wouldn't pump every 2 hours but rather I would pump every time you feel uncomfortably full or engorged. Don't bother pumping at night if you don't need to - only do it during the day. This is what my pediatrician told me and it worked well with both babies. If your daughter is not cleaning you out, go ahead and pump out the rest, though, especially while you have clogged ducts, as this will help clear them.

Normally, you do not want to wake a newborn during the night to feed, but instead "feed on demand," or whenever the baby wakes. During the day, it is important that you feed at least every 3 hours (every 2 is more common) and so yes, you should wake a newborn to feed for the first couple of weeks during the day, but not at night. HOWEVER, a jaundiced baby NEEDS to eat to help clear out the jaundice, which is probably why your doctor instructed you to feed every two hours throughout the 24-hours. I would absolutely wake your baby every 2 hours until she loses her "suntan" and her scores are down to about 12 or below. Insist that they recheck her in about 4 days to see if she is still severely jaundiced before you begin letting her sleep a little longer at night.

I agree that seeking out a local Le Leche League would probably be beneficial for you. It sounds like you need some support! Good luck!

ADDED: I just wanted to add that you might find using a syringe or dropper to feed the formula a better idea than a bottle. A baby will not fall in love with the syringe the way she might with a rubber nipple, and so in the long-run, it is probably a better idea for you. And please don't feel bad. Breastfeeding is really hard!!! I'm on my second child, and I still struggle occasionally - just check my posts! ^_^

Have you been keeping your baby's clothes off and putting her in the sun to get rid of the jaundice? This worked for our son (1st baby). Despite putting our daughter into the sun, our daughter was still jaundice at 2 months. The midwife made me to do the same thing where I fed her formula for 24 hours. After that, her jaundice started going away. Sometime breastmilk doesn't trigger what it is supposed to in order to flush the jaundice out.

Breastfeeding is another story. I could type to you all day or sit on the phone with you all day talking and helping you out with breastfeeding. However, I have two little ones that I need to put down for a nap right now. LoL... Leaking while feeding from one side is perfectly normal. Frustrating but normal. I did that with both of mine. I would suggest wearing a pad on the side you are not nursing from at the moment. Or, if you care coordinated enough, I would get a manual pump and pump from the side your daughter isn't nursing on just enough so it stops leaking. You don't want to pump too much because then you will start producing more milk. What that baby eats is what you will produce. You always produce more in the beginning that what your baby needs because your body doesn't yet know how much your baby will be eating.

DON"T PUMP unless you plan to donate milk or you are wanting to store up milk. You will produce what is taken out of your breast and if you pump on top of breastfeeding, your body will think you are feeding two babies and start producing more. You have to empty your breasts each time. If you do, your body will produce even more. Eventually, your body will slow down the milk production.

I have always fed on demand. I don't believe in feeding on a set schedule. Babies will go through growth spurts and will need to eat closer together sometime and not so close at other times. Wait until she tells you she is hungry.

My best advice to you and to contact your local La Leche League leader. They do NOT cost any money. You can call them up, meet with them, email them... whatever you need for free and at any time of the day. They also hold a monthly meeting with other breastfeeding mothers, that is also free, and you can attend those to get help from the leader, from other mothers, and to hear other mother's experiences... or help them out once you become more experienced. I was raised around breastfeeding mothers and knew all about it, etc... I didn't think I needed to get in contact with a LLL leader because I wasn't having problems... I am really glad I did. You should really get in contact with one. They are a wealth of information and support! Blessings!! Wish I could write more...

Find your state and you can find a local leader:
http://www.llli.org/WebUS.html

I went through this exact thing with my first son. He was early and had jaundice bad enough that we stayed in the hospital two days extra. Let her nurse as much as she likes at this point. I basically sat on the couch for hours at a time. Pump to keep your milk up if you are supplementing with formula for very long. I got into a cycle with my lethargic, not a great nursing son that meant I had to stop nursing altogether at 3 months because my milk supply was just too low and he was not gaining weight. The lethargy is due to the jaundice which leads to poor nursing which leads to low supply and poor weight gain. I would also suggest that you call La Leche to see if they can offer you some no-cost support. I had to use the services of a lactation consultant several times, but luckily a large part was covered by my insurance.

Try and stay calm...alll of your nervous energy comes off on your baby (weird I know but true). I was a stay at home mother with my first child and still had to pump, it just means that your milk is coming in and that your child is feeding from it - something is working, even if you think she falls asleep. Again, your milk is coming in and your breast are adjusting to how much milk to produce (all hormone related). I know its all overwhelming but know that after a few weeks (maybe 2 months) your body will adjust.

Last biggest perk for pumping - you can freeze your milk and give to your baby at a later date. This at least allows you to leave your baby to run errons without having to be next to you 24 hrs a day.

Hope this helps -
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Sounds a lot like me with my son. My son was born at 36 weeks 4 days.. and Jaundice ususally gets worse around day 3-5, then hopefully better - sounds like you are going in the right direction. Breast feeding is best, but perhaps try formula every other feeding for 3-7 days to help her get the biliruben out of her system.

Be sure the areola and flanged lips sounds perfect based on what I was taught in my nursing class. Hoag Hospital in Newport Beach has a free baby hotline to help with questions, I forget the number but check the website. Keep tickling her and "pumping her arm" -- worked great for my son (just moving his arm up and down woke him up enough to eat; talk to him while she is nursing it might help too). I took a $20 class at Hoag Hospital on nursing, it was VERY helpful -- many hospitals offer classes like this for fairly cheap. Also, I am not a doctor and I dont know if your baby is small and they really want her up every 2 hours- but most newborns can go 4 hours during the middle of the night, between feedings (we did every 2 hours from morning to night and every 3-4 hours during the night, which is what was recommended by our doc) - that might really help your sanity.

The nursing will get better and easier when you and your baby get into a routine and she is getting all stages of your milk (pumping might help regulate things a bit too).

Good luck to you and your little one!

You poor thing. I have breast fed all four of my kids and each one was a different experience. Some are good latchers, good nursers, others take a lot more work. Hang in there, it will get easier I promise! The good news is that you are producing plenty of milk! When nursing one side, just put a burp cloth over the other for the drips, really common. As for the jaundice, I do know it's more common in breastfed babies. For breastfeeding help a really good resource is the La Leche League at:
http://www.llli.org/

Breastfeeding may be the most natural thing but it's definitely not always the easiest thing. You are not alone. And good for you for sticking it out and not throwing in the towel as that is so easy to do! Good luck to you.

When my daughter had jaundice my dr. said anything over 14 she would need to go back to the hospital. I am not sure if he just keeps it at a lower number because he wants to be sure to have enough time to get it under control or what. Have you been with your Dr. long? do you trust him/her? I have been with my dr. for many years. My 4 month old had jaundice when she was born, and I didn't realize how serious it was and can actually cause brain damage (I am not sure at what level this can happen) if it does not get under control soon enough. I don't say that to scare you just to say that you may want to call and ask a different dr.'s advice. As far as feeding goes, you might try a cool (not cold) wash cloth and just wash her face with it. That always helped to wake my baby back up to feed. You can get some nursing pads that will help with the boob leaking while you are feeding. I had a friend who would feed on one side and pump the other while the baby was feeding and that might be an option for you as well. a 1/2 ounce every 2 hours doesn't seem sufficient, that is really not very much food, again, I would question your dr. if you don't have a history with that dr. u might want to get a second opinion. You can also take all your babies clothes off and just leave the diaper on and put her in indirect sun light. That is supposed to help with the jaundice - you will just have to turn the heat up in your house to make sure that she does not get cold. I think that the most important thing when feeding her is that she will stop when she is full, as long as you can keep her awake to eat a full serving you should be fine. If you want to pump the rest and store it then go for it - if not don't. It's kind of like the more you use the more you make type thing so it's really up to you. Good Luck

Hi Alice. Congrats on the new baby!!! My son was born 3 weeks early and had jaundice as well. They sent us home with a Billi bed and a nurse came to us to check his Billiruben levels every day for the first 3 days. Once his levels were back to normal, the bed got picked up and we got to hold him again--he had to be in the Billi bed all day unless he was feeding or being changed. I was still able to breast feed him even though he had jaundice. If your daughter is still yellow and lethargic, you might ask for a Billi bed. It seemed to work pretty well for my son.

My breasts produced a ton of milk at first too. I'd just wear a nursing bra and keep the breast that wasn't been nursed on covered. I wouldn't worry about pumping unless you really feel your daughter isn't nursing until she's full. If that is the case, your breasts will start producing less milk. I would speak to a lactation consultant and figure out the causes of her not getting enough milk. And remember, she is probably falling asleep because she's so lethargic from the jaundice.

Good luck!!!

OKay, first off, TERRIBLE advice from your doctor!!! The number one thing you should be doing is breastfeeding!!!!!! Second, my forst son also had jaundice, also was early, also was very sleepy, all normal. You're doing all the right things; stripping the baby down, tickling, the other thing you can do it "pump" her arm while you're breastfeeding, it works! Lastly, at this age and with the jaundice, it's okay to let her hang out at the breast (IMO). Let your daughter set the schedule and then a schedule will fall into place organically. I know she's your first but take a deep breathe, follow your instincts and your daughter's needs. While she has jaundice, yes wake her to breastfeed and empty both breasts if possible, but stop when the jaundice is over. Pumping isn't as effective as a baby in getting milk out so that's why you're engorged, try bfing as much as possible, compresses and continue massaging. Engorgement is typical when you have a newborn and your supply and the baby's demand have not evened out yet. My doctor told us to undress our baby and stand by the window for the jaundice and breastfeed as much as possible, that's what we did (and we got some great photos out of it too) and it cleared up. Don't worry about the pooping, newborn babies can go a very very long time wihtout a poop because they are using all of your breastmilk to grow! Lastly, my doula who is amazing with breastfeeding issues is training to be a lactation consultant and you should try giving her a call: Elena Vogel ###-###-####. With my first child, breastfeeding was super challenging for the first month but after that it was very easy and so much more convenient than formula (I'll refrain from judgements about breastmilk vs. formula). I ended up breastffeeding him for 20 months and I'm breastfeeding my 9 month second son! Good luck to you! It's going to be ok!

It says you are from Los Angeles, so I thought I'd share another resource. Glendale Memorial Hospital hosts a breastfeeding support group every Thursday afternoon from 1-3. It's free to anyone who wants to come, and there is always a lactation consultant present. It's not the same as having a personal consultation, but she can check your latch and watch her feed and answer questions you have. I also found it helpful to listen to the issues that other moms were having (I took my baby almost every week for her first couple months.)
Best of luck to you! It does get easier.

No time to give a long answer but i wanted to give you this resource-

http://www.drjacknewman.com/

This pediatrician is super pro-breastfeeding, has videos of babies feeding on his website which may help you; he also answers your emails personally! He also has books on breastfeeding. He helped me so much with my first daughter- I had a terrible time at first.

Good luck!

I have a 3 week old girl that went through the same thing. Her jaundice levels were high as well. She was placed on photo therapy at home to try and get her bili levels lower. Luckily the machine works wonders in small amounts of time so she was able to come off the machine in 24 hrs.

We were breastfeeding and having TONS of issues with it. She wasn't latching properly and wanted to feed ALL of them time. She fell asleep while feeding too. Jaundice makes them very sleepy, thats why it is so difficult.

We had to stop breastfeeding because of the pain and I didn't feel she was getting enough to eat. I even spent money on a lactation consultant and it didn't help us. If you can continue to breastfeed I would recommend that. You can supplement with pumped milk to give her a little extra if needed. You want to keep your supply up. The more you feed and pump the more you will produce.

At this point I think you want to wake her to feed because you are trying to flush out the jaundice. Poops are the important thing...when the bilirubin starts to come out the poops turn darker yellow/brown and are smellier than normal. When jaundice leaves the body it goes backwards from toe to head, when it comes in it is head to toe...that will help you tell if she is getting better. Our girl still had yellow face and eyes after 2 weeks.

Once her levels were at 14 they no longer drew her blood...

If you have any other questions, please let me know...

Good job Mom! The NICU should have a lactation consultant. Hope you get to see her before your little one goes home. All the best!

Updated

Good job Mom! The NICU should have a lactation consultant. Hope you get to see her before your little one goes home. All the best!

breastfeeding can be very challenging, but it sounds like you're doing better than you think.

About the leaking - stuff a cloth diaper in your bra on the other side. I had the same problem & this was the only way that i could soak up all of the leaking milk.

About the not emptying you out - pump after you nurse. It'll give you a stockpile of milk and give you some relief. Those hard lumps hurt! Hint for successful pumping: hook yourself up & sit and read. For some reason, the act of reading and relaxing really worked for me & i could empty myself out from full in about 5 minutes.

About the sleepy nursing - you're doing all the right stuff. she's just all cozy and snuggly and in the best spot ever & it's making her very relaxed. Keep pestering her & it'll get better.

About the jaundice - you're doing all the right things. Keep supplementing a bit with formula. As long as the doctor is checking her & she is improving, you're on the right track. My daughter was very yellow after she was born - i know how scary this can be.

About waking her up at night to feed - as long as she is gaining weight, i would say let her sleep until she wakes up hungry (others might disagree). This may also help alleviate the sucking-for-fun since she'll be hungrier.

Hope that helps a little. Believe it or not, it'll all work itself out over time.

You're doing great!

:) M.