Prolonged Breastfeeding Jaundice

Our experience with prolonged jaundice, breastfeeding and finding our voice as parents

(Inge-Mari, Dec 2025)

Our son was born at 37 weeks and spent his first two weeks in NICU. From a few days after birth he was visibly jaundiced (yellowish), but initially this was monitored without treatment. When he was discharged we were told to return for a routine follow-up two weeks later. At that 4-week appointment his bilirubin level was over 300. Bilirubin is a natural, yellow substance constantly produced in the normal process of the breakdown and replacement of red blood cells. The liver filters bilirubin from the blood and sends it to the intestine to be eliminated, but the newborn liver can take time to process the higher number of red blood cells being broken down. He was immediately admitted for phototherapy (a medical treatment using specialised light to trigger a healing response in the body). What followed was one of the most stressful periods of my postpartum journey.

Despite good weight gain (440 g in two weeks after discharge), frequent feeding, normal nappies, and a baby who was alert and otherwise well, the paediatrician insisted that breastfeeding was the cause of the problem, but did not think that it was a case of “Breastmilk Jaundice” as he felt the level of 300 was too high for “breastmilk jaundice”. I was told to stop breastfeeding completely for 2–3 days and that my baby might be “allergic” to my breastmilk. Galactosemia (a rare genetic metabolic disorder in which a baby’s body cannot breakdown certain sugars found in breastmilk and formula) was also raised as a concern by my paediatrician, even though my baby had no other worrying symptoms of galactosemia, except for jaundice.

As a breastfeeding mother, being told to cease breastfeeding was devastating. I had worked incredibly hard to establish breastfeeding after a NICU stay and suddenly I was being told to stop, without clear evidence or a confirmed diagnosis. At this point I reached out virtually to a medical doctor who is also an International Board Certified Lactation Consultant (IBCLC) and a La Leche League (LLL) Leader: her support was absolutely invaluable.

From the very first interaction, her guidance was calm, compassionate and firmly rooted in evidence-based breastfeeding medicine. She took the time to listen and consider all the information regarding my son, not just his bilirubin number. She asked detailed questions about weight gain, feeding patterns, stool output, alertness and overall wellbeing, all of which painted a reassuring clinical picture. Through her support, I learned that:

• Breastmilk jaundice can present with bilirubin levels above 300

• Temporary cessation of breastfeeding is only recommended in very severe cases

•  A baby suspected of having galactosemia should not be given standard formula (which is what the Paediatrician was suggesting I feed my baby if we stopped breastfeeding) 

• My baby’s excellent weight gain, alertness and stool patterns were all strong indicators that breastfeeding was not harming him.

With the IBCLC/LLL guidance and the peer-reviewed literature she shared, I felt empowered to advocate for my baby. I presented this information to the paediatrician and requested that breastfeeding continue while further investigations were done. Although the interaction was difficult and at times distressing, the paediatrician ultimately agreed to continue breastfeeding and proceed with blood tests. Under phototherapy, my baby’s bilirubin dropped from 320 to 211 and we were discharged. His stools normalised (became yellow and runny) as he breastfed more often, his colour improved and he continued to gain weight beautifully.

In the weeks that followed, his bilirubin levels fluctuated mildly (around 258–259). This was incredibly anxiety-provoking, especially when I was repeatedly advised to stop breastfeeding despite negative test results for galactosemia and a thriving baby. After each re-test the IBCLC/LLLLeader reassured me that these levels were not dangerous for his age and that newborn jaundice can take up to 12 weeks to fully resolve. She continued to guide me through:

• Increasing feeding frequency

• Prioritising skin-to-skin contact

• Monitoring nappies and behaviour rather than focusing on numbers alone

• Trusting what I was seeing in my baby

  
  

Further intensive galactosemia tests also eventually came back normal. By around two months of age the jaundice resolved completely. My baby continued to thrive, rolling early, gaining weight rapidly and meeting milestones with ease.

Looking back, the most challenging part of this journey was not the jaundice itself, but how quickly breastfeeding was blamed and how little breastfeeding education exists within standard medical training. Without the evidence-based support of the IBCLC/LLLLeader, I truly believe I would have stopped breastfeeding unnecessarily.

This experience highlighted to me the vital role that IBCLCs and La Leche League Leaders play, not only in supporting mothers, but in improving outcomes for babies and bridging the gap between breastfeeding families and the medical system. I share our story in the hope that other parents would feel less alone and that healthcare providers would pause before recommending breastfeeding cessation without clear clinical indication. 

Sometimes advocating for your baby means standing your ground, even when it’s uncomfortable; and having the right expert by your side makes all the difference.

Additional resources:

1. Bratton S, Cantu RM, Stern M. Breast Milk Jaundice. [Updated 2023 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan- Available from: https://www.ncbi.nlm.nih.gov/books/NBK537334/

2. https://www.linkedin.com/pulse/so-called-breastmilk-jaundice-jack-newman/

3. https://ibconline.ca/information-sheets/breastfeeding-and-jaundice/

4. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/22-jaundice-protocol-english.pdf

5. https://laleche.org.uk/jaundice/