What Is the Connection between Breastfeeding and Jaundice?

Breast-fed infants develop jaundice 4-7 days after birth and reach a peak in 2 to 4 weeks (serum bilirubin can exceed 256.6 to 342.0 mol / L). They are generally in good condition and have no signs of hemolysis or anemia. Jaundice usually lasts 3 to 4 weeks, and gradually subsides in the second month. A few can be postponed until 10 weeks. If you stop breastfeeding for 3 to 4 days during jaundice, the jaundice will be significantly reduced, and bilirubin will decrease by 50%. If you breastfeed again, jaundice may not reappear, even if it does not reach the original level.

Basic Information

English name

breast milk jaundice

Visiting department

Neonatal

Multiple groups

Newborn

Common symptoms

jaundice

Causes of breast milk jaundice

The cause of breast milk jaundice is not fully understood so far. According to the time of occurrence, they are divided into two types: early onset and late onset. The former occurs at a time close to physiological jaundice and is believed to be mainly related to improper breastfeeding and insufficient intake; late-onset is mostly believed to be related to increased enterohepatic circulation of neonatal bilirubin metabolism, which usually occurs 1 to 2 weeks after birth Can last up to 8-12 weeks. It is generally believed that glucuronidase content is high in the small intestine of newborns (confirmed by testing) and has high activity. This enzyme, which is mainly derived from breast milk, can catalyze the binding of bilirubin to unbound bilirubin. This process is carried out in the small intestine of the newborn, and the intestinal peristalsis of children is relatively slow. This enzyme dissociates into unbound bilirubin, which increases absorption, causing breast milk jaundice.

Clinical manifestations of breast milk jaundice

Hyperbilirubinemia occurs in breastfeeding for no other reason after birth. Bilirubin often reaches 256.5 342mol / L (15 20mg / dl). Indirect bilirubin elevation is the main factor. The newborns are generally in good condition. , Good milk, normal growth and development. Jaundice can last from 3 weeks to 3 months.

Breast milk jaundice test

Blood biochemical examination: Most serum bilirubin is less than 257mol / L (15mg / dl), but it can also be more than 342mol / L (20mg / dl). Indirect bilirubin increase is the main, liver function tests are normal, and HBsAg is negative.

Breast milk jaundice diagnosis

Medical history

According to the onset of jaundice, a history of breastfeeding alone, good growth and development, no other abnormal clinical manifestations.

2. check

Serum bilirubin levels were elevated, mainly indirect bilirubin, and all other tests were normal.

3. Diagnostic Stop Breastfeeding

Because the causes of neonatal jaundice are very complicated, it is very difficult to exclude all the causes. For children with good general condition and highly suspected of breast milk jaundice, it is often clinically stopped after breastfeeding and observed. The serum bilirubin can be obvious within 48 hours. decline. You can diagnose.

Breast milk jaundice treatment

Feeding and nursing

When it is clear that breast milk jaundice is not recommended, breastfeeding is not recommended. Feed small meals frequently. Perform abdominal massage clockwise to increase bowel movement. The structure of bilirubin, the formation of photoisomers facilitates excretion from urine. Breastfeeding can only be suspended when the bilirubin level exceeds 15mg / dl. If it is significantly reduced, breastfeeding jaundice is determined and breastfeeding can still be performed.

2. Phototherapy

When bilirubin reaches 20 mg / dl, phototherapy can be given, and generally no treatment with albumin or plasma is required.

3. Supportive Therapy

Pay attention to keep warm, increase calories, nutrition, and prevent the occurrence of diseases such as infection, so as not to increase jaundice.

4. Enzyme inducer

Hepatoprotective, enzyme inducers and other drugs were given.

Breast milk jaundice prevention

During pregnancy, the mother should pay attention to food hygiene, avoid alcohol and hot products, and do not abuse drugs. After the baby is born, the mother also needs to continue to pay attention to diet and health, and closely observe the baby's skin jaundice for timely diagnosis and treatment. Pay attention to situations that appear prematurely or resolve too late or that jaundice gradually deepens or recurs.