What is the Highest Bilirubin you've ever seen? - page 5

Just curious. :wink2:... Read More

  1. 0
    I had a kid the other day with quite high bili (maybe 20ish), and one of the first things the neo ordered was to stop feeding breast milk and put the kid on a formula.

    We were very busy that day, and I never got the chance to pick his brain as to the significance of this, so...do any of you know anything about why we'd stop feeding EBM d/t high bili?

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  2. 1
    That is odd...was it a newborn? If the kid was breastfeeding, then the kid may not have been getting enough breastmilk. However there is such a thing as breastmilk jaundice as opposed to breastfeeding jaundice.

    Generally I would think our course of action would be to hydrate the kid with IV fluids and triple lights stat.
    Bortaz, RN likes this.
  3. 1
    We have had a few kids that we have stopped MBM, if the bili levels don't respond to increased fluids and more breastmilk feedings, we will stop the MBM and give formula, if the bili levels start to drop it is a true case of breastmilk jaundice. That is pretty rare though. Once the levels drop down the mom can start to breastfeed again and the levels don't really go up.
    Bortaz, RN likes this.
  4. 0
    It was a 35 weeker, about 6 days old.
  5. 1
    I think part of the problem was the 35 week--just a little immature, most premies wind up getting "lit" @ some point in time--so physiologic jaundice. The breast milk is a variable that might contribute to the problem--but it's not a reason to stop breast feeding altogether. Mom should keep pumping and store the milk. When the juandice resolves, you could start it again. Also make sure mom is getting enough fluids--the milk might be too concentrated for the baby to handle.

    Have to make sure there are no other reasons for baby to get jaundiced--ABO, virus, TPN, etc., but it should resolve with lights, fluids and a little time.

    Bortaz, RN likes this.
  6. 1
    Yeah, I'm with PRMENRS.I've never seen a formula only order for hyperbili, regardless. You are either NPO or whatever the mother's choice is.
    Bortaz, RN likes this.

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