I am most concerned about the article by Tan1 regarding the use of formula in the treatment of jaundice in "breast-fed" babies. It is true that Dr Tan suggests that stopping breast-feeding is not necessary, an approach that is seconded by Dr DeAngelis in her editorial note. This is good, because the practice of stopping breast-feeding is too common and completely unnecessary. On the other hand, this article will induce many physicians to introduce formula unnecessarily to "help treat the jaundice," a practice that is already all too common as well. I believe it also ignores the real issue, which is that too many infants are becoming hyperbilirubinemic because they are not breast-feeding, not, as implied in the article, because they are breast-feeding. Unfortunately, too many physicians and nurses working with newborns do not seem to understand that infants are not breast-feeding just because they have the breast in their mouths and are making sucking motions.
Newman J. Breast-feeding, Jaundice, and Formula. Arch Pediatr Adolesc Med. 1999;153(6):656-657. doi: