Breast milk jaundice

Persistent jaundice in the newborn caused by some unknown factor in the breast milk .

Alternative Names

Jaundice associated with breast feeding; Jaundice associated with nursing

Causes, incidence, and risk factors

Jaundice (yellowish tinge to the skin and/or eyes) in the newborn, or neonatal jaundice, is a common and normal occurrence caused by excess bilirubin (a breakdown product of hemoglobin made by the liver). All babies have some degree of jaundice, which is called "physiologic jaundice of the newborn." Breast fed babies often have more severe jaundice. This is known as "breast feeding jaundice." While there is no scientific proof, some experts think this exaggerated jaundice provides the baby with antioxidant effects, protecting the infant from tissue injury or disease. If the jaundice persists in an otherwise healthy and thriving breast fed infant past 28 days, and the total bilirubin level is greater than 5.9mg/dl (100umol/l), this condition is called "breast milk jaundice." The cause is unknown, and no illness has been attributed to it, but it is important to be sure the baby's liver functions are otherwise normal.

Signs and tests

  • blood test for
  • bilirubin
  • breast milk
  • pregnanediol
  • assay (seldom)
  • bilirubin conjugation (the process of hooking a sugar molecule onto bilirubin so it can be excreted) will be high
  • Treatment

    If breast milk jaundice is worrisome, a mother can stop nursing for 24 to 48 hours, which will result in a rapid drop of bilirubin . She can express the milk or pump her breasts to maintain comfort and the flow of milk and bottle feed the baby in the interim. When nursing is restarted, the bilirubin will not return to previous levels.

    Expectations (prognosis)

    Full recovery is expected.

    Complications

    There are usually no complications.

    Calling your health care provider

    Call for an appointment with your health care provider if you are breast feeding your baby and the baby becomes severely yellow ( jaundice ), or if newborn jaundice lasts for longer than one week.

    Prevention

    Breast milk jaundice is not preventable. It is important to recognize early that your baby looks yellow and have bilirubin levels checked right away to make sure that there are no other liver problems. Breast feeding jaundice (which occurs during the first week of life) can be limited by making sure your baby is getting enough breast milk. Give your baby unlimited time at each breast, and feed approximately 10 to 12 times per day starting from the first day of life. Get help from a lactation consultant or your doctor as soon as possible if you experience any difficulty.

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