HJ: how about 1/2 BM and 1/2 FM? I did hear of such cases of BF jaundice, but it's a temporary thing. I just started giving V BM mixed with FM and she has been cleaning out her bottles ... dunno if she misses BM cuz I remember she prefers BM to Fm when she was younger.
OK time to BF liao ... HJ dun be discouraged ok *Hugs*
Arias first described breast milk jaundice (BMJ) in 1963. Breast milk jaundice is a type of neonatal jaundice associated with breastfeeding. It is characterized by indirect hyperbilirubinemia in a breastfed newborn that develops after the first 4-7 days of life, persists longer than physiologic jaundice, and has no other identifiable cause. It should be differentiated from breastfeeding jaundice, which manifests in the first week of life and is caused by insufficient production or intake of breast milk.
Pathophysiology
The etiology of breast milk jaundice is not clearly understood, but the following factors have been suggested to play a role:
An unusual metabolite of progesterone (pregnane-3-alpha 20 beta-diol), a substance in the breast milk that inhibits uridine diphosphoglucuronic acid (UDPGA) glucuronyl transferase
Increased concentrations of nonesterified free fatty acids that inhibit hepatic glucuronyl transferase
Increased enterohepatic circulation of bilirubin due to (1) increased content of beta glucuronidase activity in breast milk and, therefore, the intestines of the breastfed neonate and (2) delayed establishment of enteric flora in breastfed infants
Defects in uridine diphosphate-glucuronyl transferase (UGT1A1) activity in infants who are homozygous or heterozygous for variant Gilbert syndrome promoter polymorphism
Please see Jaundice, Neonatal for an in-depth review of the pathophysiology of hyperbilirubinemia.
Frequency
United States
Jaundice occurs in 50-70% of newborns. Moderate jaundice (bilirubin level >12 mg/dL) develops in 4% of bottle-fed newborns, compared to 14% of breastfed newborns. Severe jaundice (bilirubin level >15 mg/dL) occurs in 0.3% of bottle-fed newborns, compared to 2% of breastfed newborns. A strong familial predisposition is also suggested by the recurrence of breast milk jaundice in siblings.
International
International frequency is not extensively reported but is thought to be similar to that in the United States.
Mortality/Morbidity
Breast milk jaundice in otherwise healthy full-term infants rarely causes kernicterus (bilirubin encephalopathy). Case reports suggest that some breastfed infants who suffer from prolonged periods of inadequate breast milk intake and whose bilirubin levels exceeded 25 mg/dL may be at risk of kernicterus. Another group of breastfed infants who may be at risk of complications are borderline premature infants (36-37 weeks' gestational age) who are poorly nursing.
Race
Whether racial differences are observed in breast milk jaundice is unclear, although an increased prevalence of physiologic jaundice is observed in babies of Chinese, Japanese, Korean, and Native American descent.
Sex
No sex predilection is known.
Age
Breast milk jaundice manifests after the first 4-7 days of life and can persist for 3-12 weeks.
cos I worked in a place where there have been many many cases of H1N1.. same place as Astro.
