Breast milk jaundice

Causes and Risks:
Jaundice in the newborn, or neonatal jaundice, is a common and normal occurrence. Bilirubin , the yellowish pigment responsible for jaundice, is a chemical that dissolves readily in fats or oils but is not very water soluble. Bilirubin is eliminated by chemically hooking a sugar molecule to the bilirubin molecule, which then makes the bilirubin water soluble. In its water soluble form, bilirubin can be excreted in the urine.

Breast milk contains a hormone, pregnanediol , that interferes with the body's ability to hook the sugar onto the bilirubin. Some mothers, approximately 1 out of 200, have breast milk pregnanediol levels high enough to severely interfere with this process. Their infants become more jaundiced, have higher bilirubin levels, and the jaundice lasts longer than in other infants. Some breast fed infants may remain mildly jaundiced up to their third month of life. No illness has been attributed to the elevated levels of bilirubin caused by this means, but the high levels (sometimes approaching 20 mg/100cc) are worrisome.

Prevention:
This disorder is not really preventable in a breast fed infant; however if it occurs, stopping nursing for a day or two and then restarting is effective treatment.

Symptoms:
  • jaundice in a breast-fed newborn that last longer than a week



Signs and Tests:



Treatment:
Stopping of nursing for 24 to 48 hours will result in a rapid drop of bilirubin . The mother can express the milk or pump her breasts to maintain comfort and the flow of milk. When nursing is restarted, the bilirubin will not return to previous levels.

Prognosis:
Full recovery is expected.

Complications:
There are usually no complications.

Call Your Healthcare 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.


Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice persisting longer than 3 to 4 days, or worsening rapidly, should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.