Breastfeeding during breast milk jaundice - a pathophysiological perspective

@#Introduction: Exclusive breastfeeding for the initial six months of life is crucial and it is recommended . Breast milk jaundice is an innocuous condition that occurs in some healthy, breastfed infants. However, the potential dangers of jaundice in the neonate such as bilirubin induced neuronal pathology, mandates a better understanding of the pathophysiology of breast milk jaundice and the impact of breastfeeding during jaundice. In this context , advice on continued breastfeeding must consider both the benefits of breastfeeding and the possible disadvantages of the jaundice. Methods. Reviewing literature and integrating relevant information facilitated the appraisal of this important topic. This article reviewed neonatal jaundice, the entry of bilirubin into the immature brain and how breastfeeding may impact jaundice in the neonate. Results. While some substances in breast milk may be responsible for jaundice on the one hand, there is an irrefutable spectrum of advantages conferred by continued breastfeeding, on the other. As the breastfed infant benefits from fewer infections, enhanced organ and physiological barrier maturity, as well as the prospect of genetic modification of certain diseases, these useful actions could also reduce risks of early jaundice and its complications. Discussion. An exciting field for further research, holistic integration of knowledge clarifies both the overall advantages of breastfeeding and wisdom of its continued counsel. In fact, breast milk jaundice may reflect a holistic expression of tissue protection and enhanced neonatal survival.

The Effect of Continuing Breastfeeding during Treatment of Breast Milk Jaundice / 대한주산의학회잡지

PURPOSE: Though it is a general and common method to temporarily stop breast feeding and use whole milk instead for neonatal breast milk jaundice, it may cause some difficulties in continuing breast feeding after the recovery. We study the effect of continuing breast feeding on the treatment of breast milk jaundice and the success of breast feeding afterwards. METHODS: We retrospectively analyzed the medical records of 59 neonates who were admitted to Cheil general hospital from Jan 2008 to Aug 2012 for phototherapy due to breast milk jaundice. Subjects were divided into two groups, one with continuing breast feeding (35 cases) during treatment and the other with stopping breast feeding (24 cases). We examined and compared the changes in the level of serum total bilirubin between two groups, as well as the difficulties the mothers might had in continuing or restarting breast feeding after the discharge. RESULTS: There was no significant difference in times of treatment (until reaching the level of serum total bilirubin <13 mg/dL) between two groups (P=0.066). However, the group with temporary stop of breast feeding had difficulties such as nipple confusion and breast engorgement compared to breast feeding group (P=0.001). In long-term follow up, the breast feeding duration (P=0.017) and the rate of exclusive breast feeding for 6 months (P=0.024) were also significantly higher in breast feeding group. CONCLUSIONS: We suggest that continuing breast feeding while treating breast milk jaundice is helpful both for successfully continuing breast feeding and preventing problems after discontinuing breast feeding.

The relationship between Gly71Arg and TATA box polymorphism of UGT1A1 gene and prolonged hyperbilirubinemia of breast milk feeding infant in Korean / 소아과

PURPOSE: It has been known that breast milk cause prolonged unconjugated hyperbilirubinemia. UGT1A1 is a important gene of uridine diphosphate glucuronosyltransferase (UGT) which has a major role of bilirubin metabolism. These findings suggest that there is a relationship between UGT1A1 gene mutation and prolonged jaundice of breast feeding infant. The aim of study was to investigate whether a polymorphism of the UGT1A1 gene exist in prolonged hyperbilirubinemia of breast milk feeding Korean infant. METHODS: The genomic DNA was isolated from 50 full term Korean neonates, who had greater than a 10 mg/dL of serem bilirubin after 2 weeks of birth with no significant cause, and the other genomic DNA was isolated from 162 full term Korean neonates of the control population. Both group fed breast milk. We performed direct sequencing of TATA box and Gly71Arg polymorphism of the UGT1A1 gene. RESULTS: Two of the 50 neonates with hyperbilirubinemia had AA polymorphism, and 40 had GA polymorphism. Five of the 129 neonates of the control group had AA polymorphism, and 4 had GA polymorphism. The allele frequency of G>A polymorphism in the hyperbilirubinemia group was 44.0%; it was significantly higher than 5.4% of the control group. TATA box polymorpism was not different both group significantly. CONCLUSION: Our result indicated that Gly71Arg polymorphism is associated with the prolonged hyperbilirubinemia of breast milk-feeding infant in Korean, while TATA box polymorphism is not associated with the prolonged hyperbilirubinemia of breast milk-feeding infant in Korean.

Influence of Breast Milk Jaundice on Renal Function and Its Early Interference Treatment / 实用儿科临床杂志

Objective To investigate the renal function changes of the children with breast milk jaundice(BMJ) and effect of early interference treatment on renal function. Methods Serum bilirubin and urine - minim protein (?2-MG,?1-MG, Alb and IgG) of the 50 patients with BMJ were measured when they were in hospital within 12 hours and the last day separately , at the same time, 20 healthy newborns had been chosen to serve as control group. Results Compared with control group, the urine minim protein of treatment group increased with the rise of serum bilirubin. When serum bilirubin was 205.2 - 256.5 ?mol/L, urine ?2- MG had mild increasing (P