RJ and I had breastfeeding problems after she was born. Then she developed jaundice which extended our hospital stay. When she was around 4 days old, the jaundice was bad enough to require medical intervention — phototherapy.
I cried. I felt that it was my fault for not suggesting that she be fed formula while we worked out our breastfeeding problems. None of the medical staff at the hospital suggested formula to me (although they bent over backwards to send in lactation consultants). A family friend (who works as a nurse in the Children’s Emergency department) had suggested that I feed the baby formula and pump like crazy until my milk came in, but after I gave birth I told the nurse that I intended to breastfeed (and she wrote it on the whiteboard in my room) and from that point on, the word ”formula” became taboo. I was too dazed and sleep-deprived for the first few days to do what, in retrospect, I should have done. Finally, after watching RJ starve for a couple of days, I surreptitiously rang the bell for the nurse at 3am and begged her to help me give some formula to RJ. I felt like a failure.
In reality, that was probably the moment that I found my mommy-voice and put some faith in my parenting intuition. But enough of the touchy-feely personal anecdote, let’s get to the research.
Jaundice is a common health concern in newborns: up to 80% of full-term babies will have some jaundice (Maisels, 2015). It can, however, cause brain damage if left untreated. According to a medical review in the March 17, 2015 issue of the Canadian Medical Association Journal, Canada has the highest rate of brain damage due to complications for newborn jaundice in the developed world (Maisels, 2015).
Phototherapy is not the last resort against brain damage caused by hyperbillirubinemia (the build-up of the bio-molecule that causes jaundice). Phototherapy is used to prevent the need for a blood exchange transfusion, which is a more serious intervention. This article, however, argues that we may be overusing phototherapy: for every 3000 infants who receive phototherapy, only one infant is prevented from requiring a blood transfusion (Maisels, 2015). This is no small matter, as DNA damage is a potential side-effect of phototherapy.
And this is where the article gets quotable. The author suggests that rather than jumping to phototherapy to treat jaundice…
we should consider other options, such as improved lactation support or formula supplementation. This latter option, although opposed by some, deserves serious consideration when one considers the alternative and cost of hospital admission and phototherapy to a blindfolded infant, an intervention that interferes with parent-infant bonding, interrupts breastfeeding, and is, at the very least, disturbing for the parents (Maisels 2015, p. 342)
The author then goes on to describe a couple of studies that have shown formula supplementation to be an effective treatment for jaundice. One study showed that substituting formula for breast milk for two days was as effective at treating jaundice as phototherapy (Maisels, 2015).
I know which one I’d choose.
Source: Maisels, M.J. (2015). Managing the jaundiced newborn: a persistent challenge. CMAJ 187(5), 335-342.