Total Breastfeeding and Jaundice

So I promised to follow up on breastfeeding and its "perils" with regard to jaundice.. It is a fact that breastmilk wins formula milk hands down, no doubt about that.. and when you are given lessons in how to breastfeed, or plow through the breastfeeding literature, they will all tell you TOTAL breastfeeding is the way to go - i.e. do not give the newborn baby any supplementary feeds of formula milk, the little (2.5ml or so of colostrum before the breastmilk comes in will be sufficient for your baby)..

And lacticians will also warn you about the perils of feeding formula milk in a bottle and their adverse impact on your efforts to breastfeed, e.g. baby's refusal to suckle after that, nipple confusion, not enough milk supply etc etc - all the bad stuff which make you feel that if you so much as give 1 feed of formulae milk, your effort at breastfeeding will go down the drain....

So many new mums will end up like i did the 1st time, refuse to give the baby any formulae or water.. for most cases, the milk does and will come in eventually and the baby thrives, babies do and can survive on the colostrum for a few days, provided the mum feed really 6-8 times a day to stimulate the release of the colostrum, i.e. mum probably only get to sleep for no more than 2 hrs each night..

However, all the ang moh books on breastfeeding forgot about the very Asian condition of jaundice, or rather, they seemed to have missed the situation where the baby has jaundice and is in need of fluids to flush out or reduce the bilirubins (the thing that causes jaundice). So for En, he ended up with jaundice level of 480, which was diagnosed as potentially fatally harmful to his brain development, and made us worried and guilty like hell the last time.. And it did not help that a doctor suggested blood transfusion as the solution, i.e. change all the blood in the baby as the quickest way to get rid of the bilirubin... duh, how can a frail 5day old baby go through a blood transfusion..

And upon that we realised that babies with jaundice need a lot of fluids to help rid of the jaundice.. yet this runs contrary to the edict of total breastfeeding.. for it is true that once baby is supplemented with formula feed, it is tough for the mum to generate as much breastmilk to catch up with the baby's intake.. so we need to be moderate in our approach too

When we admitted En into the hospital the last time, we got an all round scolding from the nurses in the neo-natal ward (bet they were not on good terms with the lacticians who were the evanagelists of total breastfeeding).. one nurse told me point blank - "the breastfeeding books are written by Ang mohs, their bodies and ours are different right?" Righttt..when i went for breastfeeding class, all the foreign ladies already had their milk in on the second day of birth, and we Chinese struggle to produce even colostrum lor...

So this time round with Xuan, we saw 2 incidents which validated our experience.. my next bed neighbour is an older couple with us with their first born, and they were totally enchanted by the kid.. and mum was quite pro breastfeeding so as to give the best to the kid, but i overheard that their baby also has jaundice.. so got NJ to have a man-to-man talk with the daddy to be moderate in their total breastfeeding..that their baby may need the fluid if the milk has not come in and if the jaundice seems really bad.. NJ even taught him how to test for jaundice.. the older man must be wondering whether kiddo NJ's advise can be trusted..

Then when Xuan was admitted to hospital for jaundice (even with supplements of formula already, his jaundice level still kept increasing), NJ saw another couple whose baby was also down with critical jaundice and even had blood in the stools, and all because the wife was also on total breastfeeding without any supplements at all.. so the wife was crying, probably full of guilt, her mum was scolding all the way, nagging about why she did not feed milk or water and the dad was at a loss.. NJ could totally emphathise as that was what happened to us the first time round, so plucky NJ actually went to tell the mum not to scold the daughter anymore.. (wow!) and spoke to the dad about managing expectations of breastfeeding with the jaundice condition..

I think being 2nd time parents did give us an advantage even though we look quite young compared to the other couples we saw in the hospital.. and given our experience, NJ also had the courage to speak up and advise these "newbies" to avoid the same pitfall as we did.. we are not saying dun breastfeed, but to assess the condition of the baby esp. with regard to jaundice..

Many said most Asian babies have jaundice and it is not a critical illness, that is also true, but not so when you are total breastfeeding esp. when the fluid provided is not enough to flush out the jaundice... after all we also learnt through experience that jaundice can cause brain damage if it climbs too high, how come no one warned us of that before? Everyone speaks of jaundice as if it was a minor condition, so when we told frens that baby was admitted for jaundice, and some said its nothing to be worried about.. well, wait till they are parents I guess.. :)