chapter 4 : 1st pediatric appointment / breast milk jaundice

last friday, we had aj's first doctor's appointment and there were a couple of concerns:

1 - drop off in weight - aj was born 7 lbs and when he left the hospital 2 days later, he was at 6 lbs 9 oz. at the doctor's, he weighted in at 6 lbs 2.5 oz. technically, still a reasonable weight loss (average newborn loses 10% of their original weight) but ...

2 - hint of yellow in skin - aj was looking a bit jaundice. his bilirubin level at the hospital was only 8 but his current skin tone was quite yellow. bilirubin is a yellow fluid that forms when red blood cells break down. so, aj had to take a blood test that day to see what his bilirubin levels are and go back to the doctor's for a weight check the next day. so it was recommended that we supplement with formula to get his weight up and have him pee and poop more to get the bilirubin out. so our goal that evening was to fatten our little peanut! i breast fed and supplemented with formula every 2 hours. later that evening we got the bilirubin results back at 17. 17 is quite a jump from the 8 at the hospital but not a high enough level to have aj in phototherapy.

so the next day, saturday, we went back to the doctor for our weight check and he was 6 lbs 8 oz! he had gained almost 6 ounces in less than a day! however, the doctor wanted us to go and get another blood test as he still looked quite yellow. the results from that day was a bilirubin of 18. so again, the doctor wanted us to continue to feed him and have him in indirect sunlight.

on sunday, we went back for another round of blood test (this, if you haven't been keeping track is 3 days in a row now of having little aj's foot pricked)! the level increased another point to 19. the doctor deduced that aj had breastmilk jaundice. the other thing i didn't mention is that aj and i have different blood types. i am o+ while aj is a+. so my red blood cells are breaking down his red blood cells. so the doctor suggested that i stop breastfeeding for 24-48 hours!!! i can continue to pump to ensure adequate milk supply but we had to give aj formula and then return for another blood test the next day to see if the level decreases. so every 2-3 hours, s would feed with formula while a pumped. it's very very exhausting having to clean the pump equipment every 2 hours.

so after a 4th straight day of blood work (which i have to proudly say, he doesn't cry when getting pricked), we were relieved to hear that after he stopped drinking breast milk, his level dropped to 17.3. so the doctor recommended that we continue with formula for another day and if his level drops to less than 15 the next day, i can resume breast feeding. it was actually a blessing in disguise as my breasts were so sore and cracked; it was a nice break to let my breasts heal. however, i was very paranoid about having aj go 2 straight days on the bottle. i had scheduled a private session with a lactation consultant on monday but had to reschedule for wednesday morning.

so, FINALLY, tuesday was the final day of aj getting his blood drawn. thankfully, his bilirubin level came in at 14.9!!! just barely passed! we were so relieved because we didn't want to have to continue to go to the hospital to draw his blood or have photherapy! once we got the wonderful news that he was cleared to drink my breast milk that evening, s fed him breast milk through a bottle as i didn't want to continue to have him latch incorrectly. i decided that since my appointment with the lc was the next morning --- i would have aj back on my breasts then!