As a Postpartum Doula I am often the first person to provide hands on help and support with a new family. Postpartum support should ideally start from the moment you get home, which is why I have so much experience of helping families navigate this particular problem. Many of my clients (in fact most) come home from hospital with babies that have borderline jaundice results; but what I have noticed is that none of them are given actionable guidance and advice for the first 72 - 96 hours (3 - 4 days) at home prior to their first paediatrician appointment.
That first paediatrician appointment is often crucial for babies with borderline jaundice test results, if your baby's jaundice results haven't improved then it can lead to a catalyst of medical interventions. But I'm so pleased to say (although sad to see so little information about this) in the vast majority of my clients cases, some super simple protocols at home can ensure baby is on the right track, and that they pass their jaundice results with flying colours!
Jaundice in newborns is a common condition that causes yellowing of the skin and eyes. This happens when the baby's liver is still developing and cannot remove bilirubin, a substance produced by the body when red blood cells break down, as efficiently as it should. Jaundice is usually harmless and can go away on its own, but in many cases in Singapore I see interventions are recommended.
Now, if you're a parent in Singapore, you might be wondering how common jaundice is in newborns here. Newborn jaundice is one of the most common conditions requiring medical attention in newborns. In Singapore, approximately 60% of full-term babies and 85% of pre-term babies develop jaundice during the first week of their lives.
I know that sounds scary, but the good news is that jaundice is easily treatable, and most babies recover fully with proper care.
Strangely though, often not enough emphasis is given to the simplest of treatments - which can be as simple as frequent feeding. Feeding helps to stimulate the baby's digestive system and encourages the elimination of bilirubin through the stool. It's a simple equation - the more they eat the more they poo and the more they poo the more bilirubin is excreted from their little bodies.
So, if your little one is showing signs of jaundice, or has a borderline jaundice test result, it's important to make sure they're getting enough milk, whether through breastfeeding or formula. Standard advice in hospital's seems to be 3 - 4 hourly feeding, but in my experience this simply isn't frequent enough for babies with borderline jaundice levels.
MY TOP TIP
FEED EVERY 2 HOURS DURING THE DAY (3 hours at night) until you get the all clear that jaundice levels have reduced to a negligible level (normally at the first paediatrician appointment 5-8 days after birth).
As a simple example for parents that like to have a feeding guide that would be approx 7am, 9am, 11am, 1pm, 3pm, 5pm, 7pm, 10pm, 1am and 4am.
To maintain this for a few days you are likely to need to wake your baby for feeding, this especially as jaundice itself can cause sleepiness. If you are noticing it is harder and harder to wake your baby for these frequent feeds it is all the more important you maintain the feeding schedule, and also speak with your Doula, Lactation Consultant or paediatrician if appropriate, to ascertain if your baby is transferring milk well, and therefore eliminating bilirubin from their body.
Frequent feeding can even help prevent jaundice from developing in the first place! Breast milk is a natural laxative that helps the baby pass meconium, the sticky, dark substance in their bowels that contains bilirubin. So, if you plan to breastfeed, try to breastfeed your baby within the first hour of birth, and frequently thereafter.
If jaundice levels are particularly high during the first 48 hours, or have not reduced enough by the first paediatrician appointment (typically 5-8 days after birth) then interventions and treatment could include phototherapy, where the baby is placed under a special light that helps break down the bilirubin, or in some cases, a blood transfusion. This is why it is important to keep an eye out for the symptoms, extreme tiredness and lack of interest in feeding is a clear symptom to look for, and don't hesitate to seek medical help if needed.
Remember, jaundice in newborns is usually harmless, but it's still important to monitor your baby's symptoms and seek medical help if needed. With a little extra care and attention, especially with a focus on a more frequent feeding pattern, your baby will be back to their rosy-cheeked, non-yellow self in no time!
And always remember that I am here if you need me! Specialising in physical and emotional evidence based support in those first few days, weeks and months of having a baby.
All my best wishes
Kathy
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