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Two dimensions, time and relationships, were intertwined throughout the feedback received from both practitioners and all service users

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Breast Milk Jaundice Differentiate from jaundice caused by an insufficient production or intake of breast milk Breast-milk jaundice is an elevation of indirect (unconjugated) bilirubin in thriving breast-fed newborns that occurs after the first 4 to 7 days of life, and can persist for up to 3 months, with no other identifiable cause With healthy term infants: Treatment consists of increasing breast-feeding frequency, maximizing breast-feeding support and, if necessary, supplementing with expressed breast milk or formula Temporary interruption of breast-feeding is very rarely needed and is no longer recommended Supplementation with dextrose solution is not recommended Monitor weight and bilirubin levels Phototherapy is added as per guidelines Prognosis is excellent Vitamin and Mineral Supplementation of Breastfed Infants Vitamin D vitamin D deficiency may lead to rickets and osteomalacia babies are most at risk for vitamin D deficiency if: they are exclusively breastfed their mothers are vitamin D deficient they have darker skin they are not exposed to enough sunlight they live in northern communities Canadian Pediatric Society, Dieticians of Canada and Health Canada recommend that all breastfed infants should receive 400 IU of vitamin D daily from birth until one year of age, or until the infants diet includes at least 400 IU of vitamin D daily

doi: 10.1289/ehp.1408095 89