Hanyang Med Rev.  2010 Feb;30(1):17-23. 10.7599/hmr.2010.30.1.17.

Breast Feeding and Jaundice

• Choi YY

• KMID: 2053729
• DOI: http://doi.org/10.7599/hmr.2010.30.1.17

Abstract

Even though there is a strong link between breast feeding and jaundice, it is natural and it may have a partially beneficial role in the neonate. There are two types of jaundice associated with breast feeding. First, insufficient caloric intake during the first week of life may increase serum unconjugated bilirubin concentration, which is known as "breast feeding jaundice (BFJ)". This increased severity of physiologic jaundice results from the increased enterohepatic circulation (EHC) of bilirubin, but not because of a factor in breast milk. Second, prolongation of unconjugated hyperbilirubinemia into the third and later weeks of life in the healthy newborn is a regularly occurring extension of physiologic jaundice, which is known as "breast milk jaundice (BMJ)". This is caused by a factor in breast milk inhibits the glucuronyl transferase in the liver and/or increases the EHC of bilirubin. The acceptable bilirubin level in the full-term healthy breast-fed infant needs to be discussed not only to prevent unnecessary interruption of breast feeding, but also to prevent kernicterus. Optimal breast feeding practices are crucial to prevent the BFJ and to minimize the intensity of BMJ. Further research is needed to clarify the benefit of bilirubin in relation to adaptation of extrauterine life.

Keyword

Breast feeding; Neonate; Unconjugated hyperbilirubinemia; Enterohepatic circulation

MeSH Terms

Aluminum Hydroxide
Bilirubin
Breast
Breast Feeding
Carbonates
Energy Intake
Enterohepatic Circulation
Humans
Hyperbilirubinemia
Infant
Infant, Newborn
Jaundice
Kernicterus
Liver
Milk
Milk, Human
Transferases
Aluminum Hydroxide
Bilirubin
Carbonates
Transferases