All You Need to Know About Breast Milk Jaundice in Newborns

Newborns are susceptible to jaundice, a condition characterized by elevated bilirubin levels. Neonatal jaundice is particularly common during the first weeks of life, especially in preterm or late preterm infants. The increased bilirubin levels in newborns can be attributed to several factors:

• Newborns have a higher rate of bilirubin production due to the shorter lifespan and higher concentration of red blood cells compared to adults.
• Immature liver function in newborns leads to a slower metabolism of bilirubin.
• Delayed passage of meconium in newborns results in increased reabsorption of bilirubin in the intestines.
• In most cases, jaundice in newborns is known as “physiologic jaundice” and is considered harmless.

What is the Difference Between Breastfeeding Jaundice and Breast Milk Jaundice?

Breastfeeding Jaundice:

Breastfeeding jaundice, also known as suboptimal intake jaundice, typically occurs within the first week of a newborn’s life while breastfeeding is being established. Inadequate milk intake can lead to elevated bilirubin levels due to increased reabsorption of bilirubin in the intestines. Additionally, inadequate milk intake can delay the passage of meconium, which contains significant amounts of bilirubin transferred into the infant’s circulation. It is important to continue breastfeeding, and increasing the frequency of feeds can help reduce the risk of jaundice.

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Breast Milk Jaundice:

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Breast milk jaundice commonly manifests in the second or later weeks of a newborn’s life and may last for several weeks. The exact mechanism behind breast milk jaundice is still unknown, but it is believed that substances in the mother’s milk inhibit the infant’s liver from processing bilirubin effectively.

Treatment:

• Ensuring that the baby receives an adequate milk supply is crucial.
• Breastfeed the baby approximately 10 to 12 times a day, starting from the first day. Watch for hunger cues, such as alertness, sucking on hands, and smacking lips.
• Seek assistance from a lactation consultant to ensure correct latch and assess milk flow.
• Phototherapy is a common treatment for jaundice. Other therapeutic options include temporary supplementation with donor human milk or infant formula, and in rare cases, temporary interruption of breastfeeding.

Should a Mother Continue Breastfeeding if Her Child has Jaundice?

In most instances, breastfeeding can be continued, even if the newborn has jaundice. More frequent breastfeeding can help improve the mother’s milk supply, leading to better caloric intake and hydration for the infant, thus reducing elevated bilirubin levels. In rare cases, a temporary interruption of breastfeeding (12-48 hours) with replacement feeding may be recommended to aid in the diagnosis of breast milk jaundice. Ongoing clinical assessment, including repeat bilirubin level tests, will determine when breastfeeding can be resumed.

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During temporary breastfeeding interruption, it is crucial to help mothers maintain their milk production.

Should a Jaundiced Breastfed Infant be Supplemented?

In some cases, supplementation may be necessary for healthy, term infants with jaundice, as outlined in the Academy of Breastfeeding Medicine’s clinical protocols. However, the decision to supplement a jaundiced newborn should be made on a case-by-case basis.

Remember to consult a healthcare professional for personalized guidance and support when dealing with breastfeeding jaundice or breast milk jaundice.

Sources: https://ncvc.org
Category: Health