A breastfeeding guide

Normal jaundice and breastmilk jaundice syndrome
If your baby's skin is developing a distinctive yellow tint, he may have normal jaundice, which affects approximately 50 per cent of all babies in the second to fourth day after birth. Most babies do not require treatment for jaundice but, if a blood test shows that the level of serum bilirubin (bile in the blood) is excessively high, your doctor may suggest phototherapy (light therapy) to help speed up the elimination of the bile which causes the yellowish tint. All infants with jaundice need to be monitored by a physician because of the association of high bilirubin with brain damage.

However, breastmilk jaundice syndrome is a rare condition affecting 2 to 4 per cent of breastfed newborns. It usually appears toward the end of the first week, peaks at ten to fifteen days, and may last three weeks or longer. Breastfeeding should not be interrupted because of either the normal jaundice or breastmilk jaundice syndrome. In fact, frequent unrestricted breastfeeding can be helpful to both the mother and the baby.

Who to turn to for help
The first three to five days after birth are crucial for successful breastfeeding. With the recent policy of discharging a new mother and child from the hospital 24 hours after birth, the onus lies firmly on the shoulders of the new parents to find help with breastfeeding.

You may think that breastfeeding will come naturally but, like most aspects of parenting, breastfeeding is a learned art. If you haven't set up breastfeeding support before your baby's birth, don't leave the hospital without a phone number to call with questions. You may also need someone who will meet with you, if needed, to coach and encourage you through any problems you may encounter.

Finding answers to a breastfeeding problem may be as simple as a phone call to your sister. Or maybe you have a friend who has nursed before, and you feel comfortable whipping off your top in front of her. She, too, has fallen in love with your baby and is more than willing to work with both of you on the mechanics of nursing. Or perhaps it's midnight, your breasts are rock-hard with engorgement, your baby's screeching and you feel you have no one to turn to. You're wrong.

With the decrease in the length of the hospital stay has come an increase in support to breastfeeding mothers. A good place to start is the hospital where you gave birth. A nurse will be able to give you some over-the-phone help and, if your hospital has a breastfeeding clinic, you'll be invited to join. Some hospitals also have a "warm line" which new mothers can phone for advice and support. You could check with your family physician who is trained to help you or who may refer you to a nurse, a midwife, or a lactation consultant -- a person who is fully informed about all aspects of breastfeeding. Another good source is your public health unit. Check the local or municipal Blue Pages in your telephone book. Public health nurses can offer everything from home visits to 24-hour phone-in lines to well-baby clinics to drop-ins.

La Leche League Canada may be a helpful source for you. La leche is Spanish for the milk and La Leche League is the largest women's health organization in the world, with more than three thousand breastfeeding support groups in 48 countries. Chances are that there's a group near you that can offer mother-to-mother support, monthly meetings, and telephone help. To locate your closest group, check for La Leche League in the business section of your phone book or call their Breastfeeding Referral Service at 1-800-665-4324.

You may also want to read The Womanly Art of Breastfeeding (6th edition, 40th anniversary, 1997), La Leche League International's runaway bestseller, considered by many as an essential resource for the breastfeeding family. Or watch one of their videos. The 60-minute video The Art of Breastfeeding
was made, in part, by La Leche League Canada.