Breast Milk Jaundice

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Breast Milk Jaundice

Jaundice is a disorder that can affect any newborn, but occurs more often in breastfed infants. A certain amount of jaundice (also called breast milk jaundice) in a breastfed baby who is feeding well, pooping regularly, and gaining weight is perfectly normal and nothing to worry about, even if it persists over several months.

Jaundice occurs because there is a large amount of a yellow molecule called bilirubin. Bilirubin is a normal part of the body; it comes from the breakdown of blood cells and other body components.

Before delivery, the placenta filters bilirubin out of your baby�s blood. After delivery, your baby�s liver and intestines take over. The liver breaks it down and the intestines push it out of the body in your baby�s poop.�Formula fed babies have lower bilirubin levels because formula makes them poop larger quantities more quickly than breastfed babies. Although controversial, many researchers believe the bilirubin levels of formula fed babies are abnormally low.

In cases of severe jaundice, breastfeeding does not cause it. It usually occurs because of a genetic or health disorder, or because the baby isn�t feeding well.�

Situations that could cause your baby to make more bilirubin or have trouble getting rid of it:

1. Poor feeding

2. Delayed or infrequent pooping (usually related to poor feeding, but could be due to an intestinal or stomach�problem)

3. Injuries from birth that caused bruising

4. If you (the mother) had gestational diabetes

5. Certain genetic traits or disorders

6. Being of Greek or Asian decent

While a certain amount of bilirubin is perfectly normal, too much bilirubin is dangerous.

Too much bilirubin can result in bilirubin encephalopathy (Kernicterus) --permanent brain damage, deafness, and cerebral palsy. Bilirubin encephalopathy is extremely rare and there are no reported cases of it in infants diagnosed with breast milk jaundice.

How do you know if your baby�s bilirubin is too high? If you give birth in a hospital, your doctor will probably test your baby�s bilirubin levels before you go home. However, jaundice can become progressively worse after you go home.

Watch for:

1. Yellowing of the skin- it starts with the head and face and may move lower and lower on the body as the bilirubin levels continue to get higher.

2. Yellowing of the white part of the eyes

3. Very few poops, or poop that continues to be dark green or black after 2 days

There is no one perfect level for bilirubin because the acceptable levels are different based on your baby's age.

Here are the �danger levels� that may lead your doctor to start treatments (keep in mind these are only guidelines. Depending on your individual situation, your doctor may start treatment at lower levels or much higher levels).

24-48 hours old: above 12

48-72 hours old: above 15

Older than 72 hours: above 17

Breastfeeding SHOULD NOT be stopped if bilirubin levels are found to be too high. Instead, the number of feedings per day should be increased and a lactation consultant should be contacted to evaluate breastfeeding and help correct any problems.

Your doctor may be concerned with knowing exactly how much food your baby is getting. Because of this, your doctor may want your baby to be fed formula or pumped breast milk from a bottle. This is usually unnecessary.

Tell your doctor you would like to do test weights (weigh the baby before and after a feeding to determine how much the baby consumed) and monitor diaper output. Your health care team may be more receptive to this plan if you have a lactation consultant help you.�

Click here for information from The Mayo Clinic on treatment for jaundice.

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