Breast milk jaundice: Time of onset of jaundice

Breast milk jaundice appears at a similar time to physiological jaundice, usually in 4-7 days, and gradually worsens. However, physiological jaundice resolves within 10-14 days, while breast milk jaundice resolves slowly, taking 3-4 weeks to resolve, and some can continue to resolve up to 12 weeks after birth.

The mechanism of breast milk jaundice is related to the glucuronidase in colostrum, and the increased activity of this enzyme can lead to the reabsorption of unconjugated bilirubin in the biliary tract, resulting in hyperbilirubinemia dominated by indirect bilirubin.

Clinical features of breast milk jaundice

1. Jaundice does not subside. It occurs during physiological jaundice, that is, 2 days to 2 weeks after birth, but does not disappear with the disappearance of physiological jaundice.

2. The degree of jaundice. It is mainly mild and moderate, and severe is rare, and unconjugated bilirubin is more common.

3. The general condition is good. The infant was completely healthy except for jaundice, had good feeding, normal bowel and bowel movements, satisfactory weight gain, small liver and spleen, normal liver function, and negative HBsAg.

4. Jaundice subsides quickly after stopping breast milk. After 48-72 hours of stopping breast milk, jaundice is significantly reduced, bilirubin rapidly decreases to about 50% of the original level, and the serum bilirubin will rise within 1-2 days after re-breastfeeding, and then slowly decline after a period of time. Bilirubin also drops to normal on its own.

5. Good nutritional development, weight gain, normal bowel and bowel movements, and normal stool color.

6. The liver and spleen are not large.

7. Normal liver function, no anemia.

8. Jaundice generally appears 4-5 days after birth, gradually worsens, and the elevated bilirubin can last for about 10 days, and then the jaundice gradually decreases, and returns to normal levels in 3-12 weeks.

What to do if you have breast milk jaundice

Breast milk jaundice is a condition in which neonatal jaundice persists for 1-2 months. The symptoms are the same as those of neonatal jaundice, which is that the skin and whites of the eyes will turn yellow.

If the jaundice persists for 2-3 weeks, you should go to the hospital for a check-up to confirm whether the baby has breast milk jaundice. Parents can take a break from breastfeeding for 3 days and switch to artificial feeding to measure the amount of bilirubin in your baby's blood. Note that milk volume is calculated at 150ml/kg.d. During the period of breastfeeding, the mother should use a breast pump to express the breast milk to keep the milk produced adequately and to allow continued breastfeeding after the jaundice has subsided.

If there is a decrease in bilirubin, it means that the cause of jaundice may be breast milk, at this time the baby can not do any treatment, parents can drink the same as usual, do not stop breastfeeding because of fear of jaundice. Babies with severe jaundice symptoms can be treated with drugs such as liver protection and enzyme inducers.

The prognosis of breast milk jaundice is good, and the jaundice resolves when breastfeeding is stopped, and there have been no reports of bilirubin encephalopathy caused by it. In order to reduce the occurrence of this disease, nursing mothers should be encouraged to start milk early, feed a small amount of milk many times, increase the frequency of stools, reduce intestinal absorption of bilirubin, and reduce the incidence of jaundice. In addition, supportive therapies such as keeping warm, increasing calories, and preventing infection should be given to prevent jaundice from worsening.