Why is my baby
yellow?
Mother and author, Martha Beck
writes in her book, ‘Expecting Adam’ * “There has been the second phase of my
education, the one that followed all those years of school. In it, I have had
to unlearn virtually everything Harvard taught me.”
In many ways, I feel the same way
about my midwifery training. I’ve had to ‘unlearn’ so much I was taught. Baby
jaundice – also known as new-born or physiological jaundice – is one example.
I left nursing college practically expecting
every new-born to become jaundiced (yellow) after the first 24 hours of birth.
This is because when red blood cells are broken down (new-borns have too many
of these), the iron is stored to make new red blood cells (in about 100 days’
time). The yellow-coloured waste is called bilirubin and sent to the skin. This
gives a baby that tanned, yellowish look. The
skin is the biggest organ in the body, and sunlight helps to break-down the
bilirubin so that they can be eliminated by the bowel and bladder.
How does nature
deal with this problem?
Colostrum or baby’s first milk
(read more about this in my previous blog) is a natural laxative that
helps to empty the bowel of baby’s first poo called meconium. Meconium is a
thick, gooey, sticky mucous so dark green it’s practically black. A tip here
for new moms is to smear Vaseline from the nape of your baby’s neck, down his
back and all over his little bottom in preparation for this. The Vaseline helps
to stop the meconium from sticking. If this happens, it
takes quite some scrubbing to clean it off.
It makes sense then that the more
often a baby feeds, the more colostrum there is available in the bowel to act
as a laxative. I’m talking about two-hourly feeds for the first 24-hours. These
are quick ‘top-up’ feeds that shouldn’t take more than five minutes at each
breast. Freebies for doing this includes bundles of bonding and stimulating
important breastfeeding hormones like oxytocin and prolactin. The new-born
also learns to latch onto the nipple while the breast is soft and Mom
gets used to the sensation of being suctioned.
How do you
know that bilirubin levels are going down?
Firstly, the baby’s skin colour
improves. Then there’s baby’s changing poo – from black meconium, to green
slimy poop that changes to dark mustard yellow to Colemans Yellow Mustard
that’s slightly frothy. After about five to 10 days your baby will produce normal, yellowish-brownish sweet-smelling breastmilk poop. Voila!
What did we go
wrong ‘back in the day’?
1.
It wasn’t standard to put baby skin-to-skin with
Mom during the first ‘magic hour’ after birth**
2.
Babies were whipped out of the delivery room. A lucky few moms were given the chance to have
a brief squiz of their new-borns, but dads were allowed in the labour room. I
squirm to recall that the babies were put into an incubator to 'warm-up' where
they cried their little hearts out, believing they've been abandoned. Its no
wonder that psychiatrists today are raking in the bucks – but that’s another
topic and another blog.
3.
Then, (I kid you not) babies were given their
first drink of sterile water (about 20 mls) from a bottle! Yip!
4.
While mothers were in hospital (five days for
normal deliveries and 10 days for c/sections) babies were trained (I blush just
writing about it) to feed four-hourly. This was to make life convenient for the
nursing staff, and ‘easier’ on the new mother when she went home
5.
During the night it was deemed essential
that new mothers were left to sleep, and ALL babies were swept into the nursery
and bottle-fed by nurse assistants or student nurses.
Sadly, some older-generation
midwives still swear by these methods and impose them whenever they can.
What can you
do to avoid baby-jaundice?
1. Learn
as much as you can about breastfeeding while you’re pregnant. The breastfeeding
“Bible” I recommend (published by the breastfeeding support group called La
Leche League International) is called “The Womanly Art of Breastfeeding”. The
title sounds horribly old fashioned, but believe me, it’s regularly updated and
is very interesting reading – besides being a useful reference
2. Find
out about a lactation consultant in your area, phone her and introduce yourself
3. Learn
about breastfeeding support groups in your area. You could even go to one of
their meetings if you have the privilege of maternity leave before you give
birth
4. Speak
to your doctor / midwife / about breastfeeding – especially when you go on your
‘hospital tour’
5. Some
women insist on “No Bottle / No Water” instructions attached to their baby’s
bassinette and 24-hour ‘rooming in’
6. Put
your baby to the breast as soon after birth as possible, insisting on
skin-to-skin – providing there are no medical complications
7. Breast-feed
as often as possible – especially during the first 24 hours while colostrum is
still available. This will also guard against hypoglycaemia
8. Luckily,
most mothers go home (all being well) on their second or third day (after a
c-section). During Covid this may be as soon as a few hours after birth. If
this is the case, make sure that you have dependable home-care e.g. an
experienced mom (mom-in-law), friend or if necessary, a midwife in
private-practice who is prepared to come to your home.
* Judy
Paitkus publishers 2000. Highly recommended especially if you are expecting a ‘different’
child.
** More about this in my next blog
