A 28 day-old baby with jaundice

A mother exclusively breastfeeds her baby. Her baby has persistent jaundice but otherwise well. The parents are very concerned.The doctor writes the following letter to the baby. The baby name is BB, and the parents are Mr & Mrs AA, for the sake of their privacy.

Dear Ms BB,

Hi, good day!

First and foremost, I would like to tell you that Mr & Mrs AA are very loving and caring parents. You must be the luckiest girl on earth to be their little girl. I believe your 2 year-old elder sister must be totally agree with me.

Just to recapitulate, your highest serum bilirubin level was only 238 umol/L when you are 10 days old. This was normal physiological jaundice. When I saw you this morning, you have grown into a 28 day-old cute little girl. You looked slightly jaundice but otherwise active, well and healthy. For your information, your father had just arrived home from his US business trip that morning. He must be tired after the long travel but for your sake, he brought you to my clinic immediately.

Please be reassured that you are a very healthy baby girl. Your problem of prolonged jaundice is just part of a normal body process. I can confidently say this because you are well, pass normal colour stool and the blood investigation is normal. Your liver function test shows you have unconjugated hyperbilirubinemia. Total bilirubin 197 umol/L, direct 7, indirect 190.

Your mother, Ms A gives you the b(r)e(a)st feed, the most nutritious food on earth. Although this may contribute to your prolonged jaundice but her decision to continue breastfeeding is the best decision.

I can see your parents are very concerned with your prolonged jaundice. Mr A had googled online for information on neonatal jaundice. Nevertheless, not all the online information is reliable. I have attached an articles for your parents to read so as to alleviate their anxiety. I hope this helps.

BREASTFEEDING A NEWBORN WITH JAUNDICE

I am privileged to be your paediatrician.

Thank you.

Yours truly,