What is breast milk jaundice How to treat breast milk jaundice
Breast milk jaundice is characterized by an increase in unconjugated bilirubin in the blood after breastfeeding, presenting with jaundice. Breast milk jaundice can be divided into early-onset and late-onset types. The time of appearance of early-onset breast milk jaundice is 3~4 days after birth, and the peak time of jaundice is 5~7 days after birth; Late-onset breast milk jaundice appears 6~8 days after birth, the peak time of jaundice is 2~3 weeks after birth, and the jaundice resolution time can reach 6~12 weeks. (Summary: Appears late, lasts long)
Causes of maternal milk jaundice in children
1. Some women's milk contains the metabolite 3-α-20-β pregnedene glycol, which is progesterone.
This substance inhibits the catalytic action of UGT (uridine diphosphate glucuronosyltransferase) and bilirubin excretion. Since 3-α-20-β pregnagindiol inhibits the conversion of unconjugated bilirubin to conjugated bilirubin, it increases the level of bilirubin in the blood.
2. β-GD (β-glucuronidase) in the intestine reduces conjugated bilirubin and reabsorbs unconjugated bilirubin. This reabsorption mechanism is called enterohepatic circulation. Glucuronidase activity in breast milk is high, increasing intestinal and hepatic circulation.
3. The lipase activity in breast milk is high, which increases the level of free fatty acids, inhibits the catalytic effect of UGT in the liver, and reduces the synthesis and excretion of conjugated bilirubin.
4. The high level of epithelial growth factor in breast milk inhibits intestinal peristalsis and increases intestinal reabsorption in breastfed infants.
Treatment of pediatric jaundice and breast milk jaundice
For breast milk jaundice, experts recommend that bilirubin levels be closely observed:
Breastfeeding is not required when TSB (serum bilirubin level) is >257 micromol/L (15 mg/dl); When TSB > 257 micromol/L (15 mg/dl), breast milk can be suspended for 3 days and artificial feeding can be changed; When TSB > 342 micromol/L (20 mg/dl), phototherapy is added.Note: Gardenia yellow is not used abroad.
Why does pediatric jaundice stop breastfeeding, and it is useful for "jaundice".
After stopping breastfeeding, formula milk was fed, the intake was increased (generally the amount of formula milk was higher than the amount of breastfeeding), under normal circumstances, eating more would pull more, the frequency of urine and urine increased, the level of bilirubin decreased, and the jaundice was reduced by visual observation. Therefore, it is often thought that it is useful to stop breastfeeding.