Special Situations and Breastfeeding
Some babies are born with conditions that may interfere with or make breastfeeding more difficult. However, in all of the following special situations, breastfeeding is still best for the baby to thrive.
Jaundice is a condition that is common in many newborns. It appears as a yellowing of the skin and eyes and is caused by an excess of bilirubin, a yellow pigment that is a product in the blood. All babies are born with extra red blood cells that undergo a process of being broken down and eliminated from the body. Bilirubin levels in the blood can be high because of higher production of it in a newborn, an increased ability of the newborn intestine to absorb it, and a limited ability of the newborn liver to handle large amounts of it. Many cases of jaundice do not need to be treated—a health care provider will careful monitor the baby’s bilirubin levels. Sometimes infants have to be temporarily separated from the mother to receive special treatment with phototherapy.
Better to Discuss with Health Care Provider
In these cases, breastfeeding may be discouraged and supplements or other fluids may be given to the baby. However, the different Pediatrics authorities (organizations) discourages against stopping breastfeeding in jaundiced babies and suggests continuing frequent breastfeeding, even during treatment. If your baby is jaundiced or develops jaundice, it is important to discuss with your health care provider all possible treatment options and share that you do not want to interrupt nursing (if this is at all possible).
Babies with Reflux
It is not unusual for babies spit up after nursing. Usually, babies can spit up and show no other signs of illness, and the spitting up disappears as the baby’s digestive system matures. As long as the baby has six to eight wet diapers and at least two bowel movements in a 24 hour period (under six weeks of age), and your baby is gaining weight (at least 4 ounces a week) you can be assured your baby is getting enough milk.
Babies with Gastroesophageal Reflux (GER)
However, some babies have a condition called gastroesophageal reflux (GER), which occurs when the muscle at the opening of the stomach opens at the wrong times, allowing milk and food to come back up into the esophagus (the tube in the throat). Symptoms of GER can include:
- severe spitting up, or spitting up after every feeding, or hours after eating
- projectile vomiting, where the milk shoots out of the mouth
- inconsolable crying as if in discomfort
- arching of the back as if in severe pain
- refusal to eat or pulling away from the breast during feeding
- waking up frequently at night
- slow weight
- gain difficulty swallowing
- gagging or choking
- frequent red or sore throat
- frequent hiccuping or burping
- signs of asthma, bronchitis, wheezing, problems breathing, pneumonia, or apnea