Breast Milk Jaundice

Breast Milk Jaundicea condition that may arise in a young baby during the first few weeks of breast-feeding.

A substance in the mother's breast milk inhibits a metabolic reaction in the baby's body so that there is a build-up of bilirubin (the pigment in bile) in the blood and the development of jaundice.

About 2% of healthy breast fed term babies develop significant jaundice (breast milk jaundice) after the 7th day of life. This is caused by the presence of an enzyme (glucuronidase) in the maternal milk that interferes temporarily with the normal bilirubin elimination pathways of the liver.

Causes of Jaundice (Breast Milk Jaundice)

As long as the rate of excretion of bilirubin in bile by the liver matches the rate of production of bilirubin from haemoglobin in the reticuloendothelial system, serum bilirubin concentration remains low and constant.

The causes of a raised bilirubin and resulting jaundice are legion and can conveniently be divided into those conditions associated with increased production of bilirubin due to increased red cell destruction (haemolytic jaundice); those which result from decreased conjugation and excretion of bilirubin due to disease of the liver (hepatic jaundice) and those which result from obstruction of bile flow after it has left the liver (post hepatic jaundice).

According to research as many as 36 percent of babies may have some elevation in bilirubin levels into the third week, yet these babies suffer no ill effects. Some are theorizing that elevated bilirubin may be normal or even have a protective factor that is not yet understood. Typically babies with late onset jaundice are thriving and no interruptions of breastfeeding are necessary in most cases.

Whichever the cause of breast milk jaundice, if the mother continues to nurse her baby, the jaundice will decrease and disappear on its own, but this may take 3 to 10 weeks. If the mother stops nursing for 1 or 2 days, substituting formula, the bilirubin levels will drop rapidly. They will not rise again when the nursing is resumed.