Breastfeeding and Jaundice. Is there a connection between breastfeeding and jaundice? Jaundice is a common condition that causes yellowish in a baby’s skin and eyes. About 60% of full-term and healthy newborns and 80% of preterm babies get jaundice within the first or second week after they were born. According to a study, infants who are breastfed are 3-6 times higher chances of getting jaundice and last a bit longer than formula-fed infants. In this article, you will learn about jaundice and how breastfeeding affects this condition.
Note: This article is solely for information sharing and knowledge. It shall not be used to supersede any experts/health professional advice.
Breastfeeding and Jaundice
What Causes Jaundice?
Jaundice is a sign of a high level of bilirubin in an infant’s blood. Bilirubin is an orange-yellow product formed in the liver from the normal breakdown of red blood cells. Jaundice is caused by the accumulation of bilirubin in the infant’s body, high level will cause a yellowish appearance in the infant’s skin and eyes. Other than their appearance, some babies will experience other symptoms like fever, poor feeding, making a high-pitch cry, and excessive sleepiness -hard to awaken.
If a baby is left untreated, the high level of bilirubin will cause brain damage and other serious complications such as hearing loss and cerebral palsy. Therefore, early detection is important and treatment shall be done before it causes any form of brain damage to the baby.
How do you examine?
Jaundice will usually appear on the 2nd and 4th day after birth. To check for an infant’s jaundice, examine your baby under natural daylight, gently press on the baby’s forehead or nose. If the skin looks yellow where you pressed, it is likely your baby has mild jaundice.
Newborns will be checked for jaundice every 8-12 hours and before discharge from the hospital. You will be required to send your newborn to the hospital between 3-5 days after childbirth, because it is usually baby’s bilirubin level is the highest, to check for jaundice. Bilirubin levels can be detected using a blood sample. Normally, the doctor will take a blood sample from the baby’s heel and in some cases, the doctor takes a blood sample from the umbilical cord.
Jaundice will go away within 2-3 weeks. If jaundice persists longer than 3 weeks, it may be a symptom of other underlying conditions or due to breast milk jaundice.
There are a few conditions that will cause your baby to develop jaundice. Breastfeeding is one of the factors and jaundice which is caused by breastfeeding are:
- breastfeeding jaundice
- breast milk jaundice
These two terms sound almost the same, one is mechanical and one is biochemical. So let me explain …
Breastfeeding jaundice is due to insufficient intake of breastmilk. It happened when there is not enough breastmilk intake and causes inadequate bowel movement to remove the bilirubin from the infant’s body. Therefore, bilirubin will be reabsorbed from the intestines back to the body and cause the bilirubin level to increase.
In this case, jaundice will happen if breastfeeding is not successfully established in the first few days, seek help from the lactation consultant. Once the breastfeeding is well established, jaundice will likely go away on its own. Breastfeeding shall continue to feed the baby more frequently which will reduce the risk of jaundice.
The number of feeding increase 8-12 times a day, help to increase the bowel movements, in turn will remove the excess bilirubin from the infant’s body.
Breast milk jaundice is something different and the exact reason is unknown. According to the experts, it is believed that the substances in the mother’s milk will somehow lower the capability of the baby’s liver to process bilirubin. It is often hereditary. Full-term babies who are exclusively breastfed will get breast milk jaundice that can last for 8-12 weeks. Breast milk jaundice will resolve itself by the 12th week after birth. This kind of jaundice will unlikely cause serious complications but the doctor will make sure all the other causes of jaundice have been investigated before a breast milk jaundice diagnosis can be made.
Continue breastfeeding, if the bilirubin level is below 12mg/dl and the baby is feeding well, gaining weight and normal production of urine and stools . Stop breastfeeding for 24hours if bilirubin level fall above 20mg/dl, combine with phototherapy to reduce the level of bilirubin.
Other causes of jaundice
- Almost 80% of preterm babies will develop jaundice, some babies will have severe jaundice and higher level of bilirubin compared to other babies. Babies who are born in week 37 or earlier might have jaundice because the liver function has not yet developed. If the liver is unable to remove it from the body and some newborns are unable to metabolize it fast enough because of their immature liver function, accumulation of bilirubin in the body will cause jaundice.
- Incompatible of the mother and the baby’s blood. Women who have an O blood type and Rh-negative blood might have babies with high bilirubin level.
- A baby who is born with bruises at birth will likely to have jaundice. Healing of large bruises can cause high level of bilirubin and your baby might get jaundice.
- A baby who has a brother or sister that had jaundice is more likely to develop jaundice.
Babies who are born with underlying conditions below :
- A baby who has a family history of inherited enzyme deficiency condition such as G6PD deficiency, has higher chance of getting jaundice.
- A baby with Crigler-Najjar syndrome- an inherited condition which affect the bilirubin-processing enzyme, has a higher risk of getting jaundice.
- A baby who is born with a blocked or defect in biliary system.
- A baby with a liver disease.
- A baby who has an infection.
Tips to prevent Jaundice from getting severe?
There is no exact way to prevent jaundice. Here are some breastfeeding tips to help you prevent your baby from getting severe jaundice condition:
- Begin breastfeeding as early as possible. Baby is the best way to stimulate your milk production and you are able to establish the breastfeeding well if you start early.
- Seek for lactation advise, to develop breastfeeding skill. If baby is latched well, he/she is able to feed well, which will promote frequent bowel movements, risk of getting breastfeeding jaundice will be minimized.
- Feed on demands, not by “schedule” for the first few weeks.
- Keep breastfeeding unless doctor advices otherwise. If baby’s bilirubin level has reached more than 20mg/dl more than 72 hours after birth, doctor may advise you to stop breastfeeding for 24hours and combine phototherapy to bring down the bilirubin level.
- Stop supplementing water to newborn.
- If breast milk is not enough, may be supplementing with formula if necessary. Keep expressing milk to keep milk production going. Once the bilirubin level has declined, you can continue breastfeeding your child like usual.
You may read here to understand more about jaundice:
Always follow up with your baby’s doctor, on issues related to the baby’s jaundice. If a baby is diagnosed with jaundice, he/she will be given appropriate treatment. Remember, keep your baby well hydrated as it will promote bowel movement to get rid of bilirubin from the body. Seek help if you have issues with breastfeeding, enough support and advice will help you establish successful breastfeeding.