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Jaundice & the Breastfed Baby

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Newborn jaundice is normal in most cases, appearing within 2-3 days post-birth, and affecting up to 60% of full-term babies.

Physiologic jaundice is caused by a buildup of bilirubin, which is produced when red blood cells are broken down. The liver is responsible for eliminating the bilirubin, but a newborn’s liver is often too immature to efficiently handle this process yet. This causes a yellow cast on the skin (which can be trickier to detect in dark-skinned babies) and the eyeballs. This resolves itself in a week or two as the baby matures further and red blood cell levels have lowered.

In a breastfed baby, jaundice is more common and tends to persist longer than a formula-fed baby (as breastfed babies are the standard, this means it’s the norm). True breastmilk jaundice, which only affects 0.5% to 2.4% of newborns, sticks around longer than one or two weeks, sometimes up to twelve (now, this shouldn’t be confused with breastfeeding jaundice, which is caused by starvation/lack of proper milk intake). Bilirubin levels might even increase at the two-week mark. None of this is a cause for concern in an otherwise healthy baby.

On how breastmilk and formula compare in causality of newborn jaundice, Dr. Sears says:

“The difference is thought to be due to an as-yet unidentified factor in breastmilk that promotes increased intestinal absorption of bilirubin, so that it goes back into the bloodstream rather than moving on to the liver. Higher rates of jaundice in breastfed infants may also be related to lower milk intakes in the first days after birth, because of infrequent or inefficient feeding.”

Hence, why medical treatments should be avoided unless truly necessary because they threaten to interrupt breastfeeding further. As breastmilk helps move the baby’s bowels to remove excess bilirubin, frequent feedings will hasten the normal bodily process.

If bilirubin levels have reached more than 20 milligrams, a health provider might recommend treatment with phototherapy (ask about fiber optic blankets, an especially good option for nursing moms).

What not to do: do not supplement with sugar water, and do not restrict the baby from breastfeeding.

Links:

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7 Tips For Nursing With Large Breasts

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Women with large breasts (and those who are also heavier all around) may face special challenges when it comes to breastfeeding.

Plus-sized women are less likely to breastfeed than normal-weight mothers, a study found. This may begin soon after birth as plus-sized mothers’ milk is often delayed to come in, causing these mothers to abandon it. Even if a mother is not curvy all around but simply has very large (DD-cup or bigger) breasts, she may struggle with unique problems that are typically not discussed in breastfeeding classes.

Unless you believe you might have gigantomastia (read about it in the links below), here are a few tips that can help.*

*Please note, I’m not plus-sized or large breasted. These tips were compiled from other sources that attest to their reliability, not from my own personal experience.

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No More Babies: How I Really Feel (Last Child Grief)

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Thoughts at 4 Months Postpartum

I only have two children, and two will be my only. We always planned to have two kids for the usual reasons: financial resources, practicality, health reasons, familiarity, and so on.

This pregnancy and postpartum were much different than the first. I suspect it has much to do with knowing they’ll be my last.

I feel the postpartum slipping away. My youngest is now four months old, which means a little more than a trimester ago he was playing, breathing, wriggling, and listening in my womb.

For these past months I’ve watched my body turn into something blooming and abundant to swollen and rumpling to deflated and limp, stressed from constant demands upon it and weak from the the endless drill of late nights and early mornings. I’ve felt unmotivated to move into a new chapter, for I know once that happens, I won’t get to call myself ‘newly postpartum.’ In my case, not ever again.

This is now the body I’m left with. Rather, this is the body I get to keep. I’ve got more skin than I had before, a herniated navel, and my hair seems to be grieving with me as it sheds like a willow in the fall.

I think I’ll say I’m no longer ‘postpartum’ when my linea nigra disappears. The first time it took a year. I think that’s when I’ll stop telling people “I just had a baby…”

Right now my body is a signpost of declarations that say this shop is closed, be back soon. I know better because my intentions are steps ahead; I know the shop is closed indefinitely. Continue reading

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Is Infant Circumcision Incompatible With Breastfeeding?

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Is circumcision the ‘Voldemort’ in a conversation about early breastfeeding difficulties? Though it’s a studied certainty that infant circumcision can have ruinous effects upon breastfeeding, it seems only the rare or high-profile breastfeeding expert dares to mention this risk by name, much less maintain an official protocol for assistance if challenges arise.

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Giving Thanks For Intact Education

It was perhaps the first beautiful day of the season and hardly anyone showed up. The morning was slow, and though I was grateful to spend a few hours outside without nearly fainting from the usually oppressive Texas heat, we had come here to talk to people… a lot of people.

The turnout did remain slight all day, but the conversations we had were meaningful. Even those who seemed to think they had no personal history with circumcision certainly had plenty to say… or plenty left unsaid, for now.

At the end of the day, though I did feel somewhat frustrated, confused and deflated, I walked away feeling mostly just thankful. The best part is, I know I wasn’t the only one.

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Thoughts On My Two Postpartums (and Maybe Yours, Too)

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My sons, myself, and my midwife at our final postpartum visit.

I had my final postpartum visit last week. My last postpartum visit EVER. Bittersweet, yes. I feel a mixture of grief and motivation. Part of me wants to apologize (to whom, I do not know) for being melodramatic. The rest of me knows no apology is needed — postpartum time deserves far more attention and care than it typically receives.

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Breastfeeding With a Weaned One Watching

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I wrote a post a while back about wondering whether 3.5 year old MaiTai would tandem nurse with his baby brother, Julep. MaiTai was still nursing regularly then, and it wasn’t until my eighth month of pregnancy that he stopped altogether (minus a few ‘test tries’ to see if the milk had changed its taste yet).

Between then and now, he’d accumulated a host of new bigger-kid needs and the long-standing breastfeeding one got booted to the back of his priority list.

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