The association of neonatal jaundice and breast-feeding

  • Rulina Suradi Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Esther H. Situmeang Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Taralan Tambunan Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Keywords: breast feeding, jaundice, term infants.

Abstract

To examine the prevalence of jaundice in neonates and its association with breast-feeding, we studied 100
healthy breast-fed baby boys during the first 3 - 5 days after birth, delivered in Dr. Cipto Mangunkusumo Hospital. This was
an analytical, cross-sectional study performed prospectively. The study was conducted from April, 1, 1999 to October 15,
1999. Jaundice was detected in 94 out of 100 infants (94%). Breast-feeding jaundice was encountered in 26 infants (28%)
namely infants whose bilirubin levels was >12 mg/dL by day 3 (CI 95% : 19;37%). Most infants showed bilirubin levels on day
two, three and five of 6 – 10 mg/dL (62%), 6 – 10 mg/dL (35%) and 12 – 15 mg/dL (34%), respectively. Several factors found
to be contributing to the occurrence of breast-feeding jaundice included : a. breast-feeding frequency (r :- 0.83, p < 0.01), b.
mean breast-feeding duration : infants breast-fed for more than 30 minutes have consequences its breast-feeding frequency
was less in compared with those breast-fed in less than 30 minutes. c. time of meconium passage (p< 0.05), meconium
passage in the first hours after birth played an important part in reducing enterohepatic circulation, d. fecal weight (r =-0.87,
p < 0.01), feces retained in the intestine its bilirubin would be deconjugated and reabsorbed subsequently . e. weight loss (p
< 0.05). In 11 infants who received blue light therapy there were no abnormalities both in physical and laboratory examinations.

References

1. Gourley GR. Pathophysiology of breastmilk jaundice. In:Polin RA, Fox WW, eds. Fetal and neonatal physiology.Philadelphia:WB Saunders, 1991;1173-9.
2. Suradi R. Hubungan pemberian ASI dengan ikterus pada neonatus. Presented in Semiloka manajemen laktasi RSAB Harapan Kita. Jakarta, October, 18-27, 1993.
3. Boedjang RF. Pendekatan diagnosis dan tatalaksana ikterus pada bayi baru lahir. Sari Pediatri 1994; 1:105-117.
4. Auerbach KG, Gartner ML. Breast-feeding and human milk : their association with jaundice in the neonate. In: Lawrence R, ed. Clin perinato. WB Saunders, 1987;14:87- 107.
5. Schneider AP. Breastmilk jaundice in the newborn : a real entity. JAMA 1986; 255:3270-74
6. Maisels MJ. Jaundice. In : Avery BG, Fletcher MA, Mac Donald MG, eds. Neonatology, pathophysiology and management of the newborn; 4th edition. Philadelphia : JB Lippincott, 1994;630-725.
7. Suradi R. Unpublished data. Division of Perinatology, Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta.
8. Kuhr M, Paneth N. Feeding practices and early neonatal jaundice. J Pediatr Gastroenterol Nutr 1982; 1:485-8.
9. Butler DA , Mac Millan JP. Relationship of breast-feeding and weight loss to jaundice in the newborn period: review of the literature and result of a study. Clev Clin Quarterly 1983 ; 50: 263. Quoted from Maisels MJ: Jaundice. Neonatology, pathophysiology and management of the newborn, 4th edition. Philadelphia: JB Lippincott 1994, 630-725.
10. Maisels MJ, Gifford K, Antle CE. Jaundice in the healthy newborn infant : a new approach to an old problem. Pediatrics 1988; 81: 505-511
11. Gartner LM, Lee KS,Vaisman S. Development of bilirubin transport and metabolism in the newborn rhesus monkey. J Pediatr 1977; 90:513-31.
12. Roberton NRC. Neonatal jaundice and liver disease. In: Roberton NRC, penyunting. A manual of neonatal intensive care, 3rd edition. London: Rowland, 1993; 238-2609.
13. Rosta J, Makot Z, Kertesz A. Delayed meconium passage and hyperbilirubinemia. Lancet 1968; 23: 1138.
14. Cottrell BH, Anderson GC. Rectal or axillary temperature measurement : effect on plasma bilirubin and intestinal transit of meconium. J Pediatr Gastroenterol Nutr 1984;3: 734-8.
15. Weisman LE, Merenstein GB, Digirol M. The effect of early meconium evacuation on early onset hyperbilirubinemia. Am J Dis Child 1983; 137: 561-6.
16. De Carvallo M, Robertson S, Klaus M. Fecal bilirubin excretion and serum bilirubin concentrations in breast-fed and bottle fed infants. J Pediatr 1985; 107:786-90.
17. Damhs BB, Krauss AN, Gartner LM. Breast-feeding and serum bilirubin values during the first 4 days of life. J Pediatr 1973; 83:1049-54.
18. Yamauchi Y, Yamanauchi I. Breast-feeding frequency during the first 24 hours after birth in full term neonatus. Pediatrics 1990; 86:171-5.
19. Lawrence RA. The management of lactation as a physiologic process. In : Lawrence R, ed. Clin perinato. WB Saunders, 1987; 14: 1-10.
20. Lawrence RA. Management of the mother-infant nursing couple. In : Kennel JH, Klaus MH, eds. Breast-feeding, 3rd edisi. Chicago. Mosby Company, 1990; 172-219.
21. Gourley GR, Kreamer B, Arend R. The effect of diet on feses and jaundice during the first three weeks of life. Gastroenterol 1992;103:660-4.
Published
2001-04-30
How to Cite
1.
Suradi R, Situmeang E, Tambunan T. The association of neonatal jaundice and breast-feeding. PI [Internet]. 30Apr.2001 [cited 29Mar.2024];41(3-4):69-5. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1241
Section
Articles
Received 2017-02-01
Accepted 2017-02-01
Published 2001-04-30