Delaware Modern Pediatrics Blog » nursing

Jaundice in Newborns

David Epstein M.D. — Tue, 10 Aug 2010 20:48:46 +0000

Did you just bring your newborn home? You might feel a bit overwhelmed. Night feedings, unwanted advice, and the sense of being on-call “24-7″ can be exhausting.

The last thing you need is to be worried that jaundice in your newborn will make everything worse. If jaundice is a concern, please have a look at this handout that I just posted. Click here to read it!

– David Epstein, MD

You can donate your extra breastmilk!

David Epstein M.D. — Sun, 14 Mar 2010 17:12:45 +0000

If you are breastfeeding, good for you (and your baby!) If you can pump some, and store some for later, so much the better. It can be stored for about 6 months in the back of your freezer. (Click HERE for more information.)

Some mothers produce so much milk that their baby can’t drink it all. Have you ever wondered how to give it away? Perhaps there’s a baby who could really use it.

Now, there’s a way to donate it. “MilkShare” is an organization dedicated to uniting babies in need with a breastmilk donor. One of my patients alerted me to this resource; she has donated milk for two families, and she’s found it to be a rewarding experience.

Donors are not expected to be reimbursed for the milk itself, but you can be reimbursed for equipment and shipping costs. (Selling the milk itself is forbidden by the site.) The recipient is also responsible for any costs for testing the milk.

Click HERE to see the MilkShare website, and find out more.

– David Epstein, MD

Pacifiers might be OK while breastfeeding

David Epstein M.D. — Thu, 16 Apr 2009 10:50:48 +0000

Breastfeeding mothers have been told for many years that pacifiers should be avoided, because of a fear that they might interfere with breastfeeding.

Now, a review article in the AMA’s pediatrics journal (April 2009) reassures us that pacifiers may be okay for breastfed babies, after all. 4 randomized trials were reviewed; babies were assigned to the “pacifier” or “no pacifier” groups. All four studies showed no effect of pacifier use on breastfeeding outcomes. In fact, more than half of babies in the “no pacifier” groups actually were given pacifiers by their parents, but these babies breast-fed just as well.

In several observational studies, babies not using pacifiers did breastfeed somewhat more, but the authors speculate that this might be due to family attitudes towards breastfeeding, rather than an effect on breastfeeding by pacifiers. That effect would be difficult to distinguish with this type of study, which is why the randomized trials carry more weight.

Why does it matter? The American Academy of Pediatrics recommends that babies should be offered a pacifier for naps and sleep after 1 month of age (after nursing is established), for the first year or so of life. (Some studies suggest that pacifiers during sleep might reduce the chances of SIDS, although this is not definite.)

So now I feel comfortable reassuring parents that it’s ok to use pacifiers when their infant sleeps. I still recommend that an alert but fussy infant should be offered a feeding before giving a pacifier, to encourage on-demand feeding. And in any event, the use of pacifiers (and bottles) should be ended by 15 months.

(Archives of Pediatric and Adolescent Medicine 2009; 163(4): 378-382)

– David M. Epstein, MD