Jaundice and starting fruits and veggies

I have a friend whose nephew is 4 months old. He nurses frequently for approx. 2 minutes per side. The child is yellow and the Dr. has told the mother that he has 'breastfeeding jaundice' but has only sent her home with no recommendations. The child also went without a bowel movement for over 10 days, after which someone told her to start fruit and veggies. The child did have a bowel movement but is this not too early for these foods? With all the other factors is there not another problem in the works for this child? The fruits and constipation started in his 3rd month.

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Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Hello,

Infants with true breast milk jaundice, which starts after the fourth day and lasts for several weeks, are usually not threatened by the level of bilirubin, and intervention is not necessary. This is probably why the Dr. sent her home with no recommendations.

Some infants develop breast milk jaundice due to unconjugated bilirubin related to some factor in breast milk or to a unique enzyme effect of gut bacteria. The levels of bilirubin will lessen if breast feeding is stopped for a day or two and formula is substituted while the mom pumps her breasts. She should then resume nursing. However, the benefit to the baby is strictly cosmetic. The risk of stopping nursing for a day or two is that the mother will not resume.

I am uncertain as to why the baby became constipated. It may be that he was not taking in enough liquid, especially in light of how little he nurses. By adding fruits and vegetables you have added some liquid to the diet which may have relieved the constipation. Four months old is about the age to begin introducing these foods because the baby now has the ability to swallow and digest them.

Bowel movements are a major preoccupation of many parents, not realizing that it is very normal for two or three days to pass without one, even in breast fed infants. Symptoms of constipation include hard stools that pass only with pain or straining, and occur less than three times a week.

For help with breastfeeding and finding ways of helping the baby lengthen the time he nurses at each breast, I suggest you have your friend call La Leche League at 1-800-La-Leche. They are experts in nursing and the problems that go along with it.

Thanks for writing.

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