Myth: Babies with 'breastmilk jaundice' should not be breastfed

Research on this topic indicates:

J Perinatol. 2001 Dec;21 Suppl 1:S25-9; discussion S35-9.Breastfeeding and jaundice.Gartner LM.

" Optimal breastfeeding practices, which result in minimal initial weight loss and early onset of weight gain, are associated with both reduced breastfeeding jaundice and minimization of the intensity of breastmilk jaundice."

Pediatrics. 2001 Mar;107(3):E41. Is breastfeeding really favoring early neonatal jaundice? Bertini G, Dani C, Tronchin M, Rubaltelli FF.

" The present study confirms the important role of fasting in the pathogenesis of neonatal hyperbilirubinemia, although breastfeeding per se does not seem related to the increased frequency of neonatal jaundice but to the higher bilirubin level in a very small subpopulation of infants with jaundice. In fact, in the breastfed infants, there is a small subpopulation with higher serum bilirubin levels. These infants, when starved and/or dehydrated, could probably be at high risk of bilirubin encephalopathy."

Ned Tijdschr Geneeskd. 2004 Oct 9;148(41):2016-9. [Optimal breastfeeding to prevent hyperbilirubinaemia in healthy, term newborns].[Article in Dutch] Semmekrot BA, de Vries MC, Gerrits GP, van Wieringen PM.

" Frequent breast feeding (at least 8 times a day) and fewer supplementary feeds will result in increased breast milk intake, less weight loss, and lower bilirubin concentrations. In the case of a breastfed infant presenting with neonatal hyperbilirubinaemia, the advice should be to breastfeed more frequently and to withhold supplementary feedings."

Nurs Womens Health. 2013 Dec;17(6):498-507. Supporting breastfeeding to reduce newborn readmissions for hyperbilirubinemia. Seagraves K, Brulte A, McNeely K, Pritham U.

"Lack of breastfeeding support can result in inadequate feedings at the breast, putting newborns at risk for hyperbilirubinemia, severe jaundice and possible hospital readmission. Nurses can help prevent readmissions for hyperbilirubinemia by becoming educated about the risk factors for hyperbilirubinemia and by implementing preventive measures through improved breastfeeding support."

 

Ital J Pediatr. 2014 Jan 31;40(1):11. Italian guidelines for management and treatment of hyperbilirubinaemia of newborn infants ≥ 35 weeks' gestational age. Romagnoli C, Barone G, Pratesi S, Raimondi F, Capasso L, Zecca E, Dani C; Task Force for Hyperbilirubinaemia of the Italian Society of Neonatology.

" Breastfed babies should not be routinely supplemented with formula, water or dextrose water for the treatment of jaundice (evidence level 1b) [7,41]. The need for additional fluids during phototherapy should be considered only when the daily weight loss is higher then 5%, or when breast milk is not sufficient to permit the full feeding."

J Biol Regul Homeost Agents. 2012 Jul-Sep;26(3 Suppl):25-9.Hyperbilirubinemia and management of breastfeeding. Soldi A, Tonetto P, Chiale F, Varalda A, Peila C, Sabatino G, Occhi L, Giuliani F, Perathoner C, Prandi G.

" The reviewed guidelines for detection and management of hyperbilirubinemia underline how prevention of badly managed breastfeeding and early support for the couple mother-child are effective prevention measures against severe early-onset jaundice; furthermore, the breastfeeding interruption is no longer recommended as a diagnostic procedure to identify breast milk jaundice because of its low specificity and the risk to disregarding the detection of a potentially dangerous disease."