Jaundice is the yellowish tint caused by elevated levels of bilirubin in the blood. Bilirubin is produced when the body breaks down old blood cells, and is processed by the liver for elimination through the bowel. A small amount of jaundice is normal in newborns, usually peaking about the 2nd-4th day and disappearing entirely by 2 weeks or so as the baby’s liver becomes effectively able to process the bilirubin. In more severe cases, the baby turns a bright golden color on the face and extending over the body.
Severe jaundice can come from anything that requires the red blood cells to be replaced – injury during a difficult birth, for example, or infection or illness. It can also come from medications such as Pitocin, synthetic oxytocin given to the mother during labor to speed up or strengthen her contractions.
Pitocin carries a host of risks, from uterine rupture and postpartum hemorrhage in mom to increased heart rate, seizures, and brain damage in baby. A risk that often pales in comparison, but is still incredibly important, is the negative effect Pitocin-related jaundice has on breastfeeding.
A jaundiced baby is normally very, very sleepy. Too sleepy, in fact, to eat or do much of anything besides nap. A certain amount of napping is normal in newborns, but these rest periods are interspersed with periods of alert observation and clusters of feedings. A jaundiced baby just sleeps and sleeps. Common advice to undress the baby, tickle the toes, etc, to wake him up for feeding just doesn’t work.
Add to this the treatment for jaundice: baby sleeping under and on special lights designed to help break down the bilirubin. Because baby isn’t sleeping next to his food source, he isn’t stimulated to wake and feed by the smell of mom’s milk. Because mom doesn’t have baby rooting at the breast as often as if he were skin-to-skin, her supply doesn’t increase as much.
The end result: Baby doesn’t gain weight, mom is frustrated, and all too often the advice to supplement with formula is the beginning of the end of the breastfeeding relationship. Mom feels like a failure for not being able to breastfeed, baby misses out, and no one benefits except the formula company.
Unfortunately most moms in the hospital are given Pitocin as a routine intervention, even if labor started naturally as it’s supposed to. It’s no coincidence that many moms struggle to establish breastfeeding even when they are supported by family and friends and have access to board-certified lactation consultants. When given Pit, many moms don’t know to question this (or any other) intervention, or to ask how this might have an effect on their ability to normatively feed their babies.
We all want every birth to end in healthy mom and healthy baby. But birth is so much more than just that! How you give birth matters. Routine interventions (meaning those that are done to most women as a matter of course and not because they are specifically needed by a specific woman) can affect you, your baby, and your sanity.
I urge you to question interventions that are offered to you. Ask what the risks and benefits are. Ask what the alternatives are. Ask what would happen if you did nothing and instead let nature take its course. And ask yourself: Is this right for me? Is it necessary? Will this intervention put me in a place I want to be, or will it ultimately lead to more frustration down the road? Once you work through your decision-making process, one of two things will happen: either you’ll say, “No, we really don’t want to do that. But we’ll let you know if we change our minds.”, OR you’ll realize that you really do need the intervention and then you can accept it with confidence, and with an advance plan to handle the side effects as they come.