RESUMO
Background: Neonatal jaundice, especially breast feeding jaundice is one of the most common causes of neonatal readmission during the first month of life. Breast feeding jaundice may be due to decreased milk intake with dehydration and/or reduced caloric intake. The aim of this Study was to determine maternal risk factors of breast feeding jaundice in order to prevent it than before
Methods: This case- control study was performed at Bahrami University Hospital, Tehran, Iran and involved 75 term exclusively breast fed newborns admitted for hyperbilirubinemia, with a weight loss greater than 7%, with one positive lab data as: serum Na and ge 150meq/lit, urine specific gravity> 1012, serum ureaandge 40mgr/dl, without assigned cause for hyperbilirubinemia. They were compared with 75 matched controls with weight loss less than 7%, without dehydration and a known cause of hyperbilirubinemia
Results: In comparison with control group, in neonates with breast feeding jaundice, inappropriate feeding practice [P<0.033], delayed onset of lactation [P<0.0001], inverted nipple [P<0.001] were significantly higher. In our study, there was no significant difference between two groups in education level of mother, learning breast feeding practice before and after delivery, method of delivery [cesarean or vaginal delivery], primiparity or multiparity and use of supplements [water or glucose water]
Conclusion: This study shows need for special attention and follows up of mothers and neonates at risk for breast feeding jaundice, especially those with inverted nipples or undergraduate for successful breast feeding. On the other hand this study shows encouraging mothers for early lactation especially in the first hour of life decreases the risk for this kind of jaundice
RESUMO
Background: The relationship between season of birth and human diseases is well known and such a relationship could be mediated by seasonal and environmental effects on early events of extrauterine life Empirical neonatological experience suggests that prevalence and degree of neonatal jaundice might be dependent on seasonal variation, mainly due to the sunshine duration. However, evidence based data on this issue are scarce. Thus, we have analyzed the seasonal effect on the rise of serum bilirubin level during the neonatal period
Methods: A prospective cohort study was done on a sample of 629 term and healthy infants born consecutively in Shariati Hospital, Tehran, Iran, during the years 2008-2009. The cord bilirubin level and then the serum bilirubin level near to 48 hour of age were measured. Seasonal differences in rise of serum bilirubin were studied
Results: Rise of serum bilirubin in spring was 3.95+/-1.4 mg/dl, in summer 3.76+/-1.69 mg/dl, in fall 3.51+/-1.60 mg/dl and in winter 4.79+/-1.99 mg/dl. Serum bilirubin level in cord blood did not appear to be correlated with season of birth. After correction for the possible effect of these variables the relation between season of birth and rise of serum bilirubin remained significant. The rise of serum bilirubin in winter was significantly higher than other season [P<0.0001]
Conclusion: Season acts as an independent etiological factor of neonatal hyperbilirubinemia. Mean rise of serum bilirubin in winter is higher than other season. This provided information to improve education for nurses in identifying risk factors and the prevention of hyperbilirubinemia readmissions