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Neonatal Jaundice
Identifying and Treating Jaundice
By Mary Weidler
Breastfeeding jaundice usually occurs because babies are breastfed before the mother's milk actually comes in. Dr. Greene says that these babies may also appear slightly dehydrated, but the best remedy for them is to breastfeed even more. "They're just not getting enough," he says.
On rare occasions, enzymes in the mother's milk can actually cause the jaundice, Dr. Greene says. "In these cases, the jaundice is often not visible until the baby is a week old and then it reaches its peak in the second or third week." Breastmilk jaundice can be caused either by enzymes in Mom's milk that deactivate the baby's enzyme for dealing with bilirubin or by the fatty acids in Mom's milk that the baby processes as a priority over processing the bilirubin.
Dr. Greene notes that breastmilk jaundice is far less common, occurring in about one in every 200 babies, as opposed to 13 percent of babies who develop breastfeeding jaundice. Breastfeeding is still encouraged for babies with these types of jaundice. "Whichever the cause, if the mother continues to nurse the baby, the jaundice will decrease and disappear on its own," Dr. Greene says, adding that this could take from three to 10 weeks. "If the mother stops nursing for one or two days, substituting formula, the bilirubin levels will drop rapidly, and they will not rise again when the nursing is resumed."
Jaundice can also be a symptom of blood group incompatibility. If a mother's blood type is different than her baby's, she may produce antibodies that attack the baby's red blood cells, resulting in a sudden increase in the level of bilirubin. This jaundice is usually evident within the first 24 hours of a child's life. The incompatiblity of blood types or Rh factor used to cause the most severe cases of jaundice. However, doctors today are usually able to identify the incompatibility prior to the baby's birth, so that they are prepared from the onset to deal with the problem.
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