Breast Milk Jaundice – Causes, Symptoms and Treatment

Breast milk jaundice is a type of jaundice that occurs in neonates due to breastfeeding. It happens within the first week of life due to the abnormal accumulation of bilirubin. Jaundice is a condition in which the skin and eyes turn yellow. It is common in newborns. Many infants get jaundice within a few days or weeks after birth. Jaundice occurs when the bilirubin content in the blood is higher than usual. Bilirubin is produced during the breakdown of red blood cells. This bilirubin releases into the intestinal tract after passing through the liver. Since the liver in infants is not fully developed, it is difficult for their liver to remove the bilirubin from the blood. Due to the excess amount of bilirubin in the blood, the skin and eyes appear yellow.

The type of neonatal jaundice associated with breastfeeding is called breast milk jaundice. It does not cause any complications in a healthy, breastfed child but can last up to 12 weeks in a few children.

The cause for breast milk jaundice is not known but linked to a substance in breast milk. It prevents the breakdown of proteins in the infant’s liver. This type of jaundice is rare and does not cause any problems when they occur.  

Breast milk jaundice and breastfeeding jaundice are not related to each other. Breastfeeding jaundice is common in children who do not get enough breast milk. 

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Symptoms of breast milk jaundice

Infants generally show symptoms of breast milk jaundice one week after birth. They are:

• Yellow pigmentation of the skin and eyes
• Poor weight gain
• High-pitched crying
• Fatigue

Causes of breast milk jaundice

Red blood cells are abundant in infants after they are born. When the body begins to destroy the old red blood cells, yellow-pigmented bilirubin is produced. Bilirubin is excreted from the body through urine or faeces. If the chemicals in the breast milk prevent the liver’s protein from breaking down the bilirubin, breast milk jaundice occurs.

Jaundice from breast milk can run in families. It affects around a third of all newborns who receive their mother’s milk and occurs equally in both genders.

Risk factors of breast milk jaundice

A family history of jaundice in breastfeeding newborns is one of the main risk factors.  

Diagnosis of breast milk jaundice

A lactation consultant examines the baby’s feed to ensure if latching occurs properly and that breast milk production is enough. A lactation consultant is a breastfeeding expert trained to help mothers learn how to feed their babies. If the consultant finds the infant latching well and obtaining enough milk, then a diagnosis for breast milk jaundice is carried out. The surgeon conducts a blood test to confirm the diagnosis. This test determines how much bilirubin is present in the baby’s blood. Bilirubin levels above a certain threshold indicate jaundice.

Treatment of breast milk jaundice

Breastfeeding the infant is perfectly safe. Jaundice is a temporary illness that should not prevent from acquiring the benefits of breast milk. A parent can monitor mild or moderate jaundice at home. The doctor will advise the mother to breastfeed the infant more regularly or supplement breast milk with formula. It assists the baby in passing bilirubin through their feces or urine.  

Treatment will be determined by:  

• The level of bilirubin in the baby’s blood steadily throughout the first week of birth. 
• How quickly has the bilirubin level risen? 
• Whether the child was delivered prematurely or not? 
• How has the baby been feeding? 

The bilirubin level is frequently within normal limits for the baby’s age. These levels are usually higher in newborns than in older children and adults. Other than diligent monitoring, there is no requirement for therapy in this circumstance. Make sure your baby is getting enough milk to avoid the type of jaundice caused by insufficient breastfeeding.

• Starting on the first day, feed roughly 10 to 12 times per day. Feed whenever the baby is awake and sucking hands or smacking lips. It is how babies communicate their hunger.  
• If the mother waits to feed until the baby cries, then feeding will be more difficult. 
• Allow babies to spend as much time as they like at each breast as long as they are sucking and swallowing regularly. Babies who do not feel hungry will relax, unclench their hands, and fall asleep.

If breastfeeding isn’t going well, seek support as soon as possible from a lactation consultant or your doctor. Babies delivered before 37 or 38 weeks are more likely to require further assistance. While learning to breastfeed, their mothers frequently need to express or pump milk to keep up with demand.

• The mother has to supply an increased amount of milk to the infant by nursing or pumping more frequently (up to 12 times a day). They have the potential to lower bilirubin levels.  
• Before you decide to feed your baby formula, consult your doctor.  
• Spending “skin to skin” time with your baby can also help you feed them better and produce more milk.

Fluids are administered through a vein to help boost fluid levels and lower bilirubin levels in babies who are not able to feed properly. 

If your baby’s bilirubin level is too high, he or she may be placed under special blue lights to help break it down (phototherapy). 

Phototherapy treats severe jaundice, either in the hospital or at home. The infant will be exposed to a particular light for one to two days during phototherapy. The light alters the structure of bilirubin molecules, allowing them to be eliminated more quickly from the body. To avoid eye injury, the baby will wear protective glasses throughout phototherapy.

Preventive measures for breast milk jaundice

The majority of occurrences of breast milk jaundice are unavoidable. Even if the parent is worried about the infant getting breast milk jaundice, try not to stop breastfeeding until the doctor advises.

Breast milk is necessary for the newborn’s health. It gives newborns all of the essential nutrients while also protecting them from diseases and infections. Breastfeeding infants eight to twelve times per day for the first six months of life is recommended.

Conclusion

With the correct therapy and close supervision, babies with breast milk jaundice frequently recover. If the child’s liver gets more effective and continue to drink enough milk, the condition usually goes away after one or two weeks. Even with careful treatment, jaundice can sometimes last until the sixth week of life. In some cases, it could be a sign of another underlying medical problem that necessitates more intensive therapy.