What should I do if my baby has breast milk jaundice?

There is a type of neonatal jaundice called breast milk jaundice, which usually appears 4 to 5 days after birth. The bilirubin level gradually increases and lasts for about 10 days, then gradually decreases and returns to normal in 3 to 12 weeks. When babies develop breast milk jaundice, many mothers are very worried. What is breast milk jaundice? Does it need to be treated?

Breast milk jaundice was first reported in the 1960s, when the incidence was about 1% to 2%. As people became more aware of breast milk jaundice, the incidence reported in the literature has been increasing year by year since the 1980s. According to relevant literature, the incidence of jaundice in normally breastfed babies 28 days after birth is about 9.2%, which is actually much higher than the reported number.

The main characteristic of breast milk jaundice is the increase of unconjugated bilirubin in the blood of newborns after breastfeeding, which manifests as jaundice. Breast milk jaundice can be divided into early-onset and late-onset. Early-onset breast milk jaundice appears 3 to 4 days after birth, and the peak time of jaundice is 5 to 7 days after birth; late-onset breast milk jaundice appears 6 to 8 days after birth, and the peak time of jaundice is 2 to 3 weeks after birth. The jaundice can subside in 6 to 12 weeks.

Three main causes of breast milk jaundice:

1. Breast milk contains 3α-20β-diol. The breast milk of mothers of children with breast milk jaundice contains 3α-20β-diol, which inhibits the activity of liver glucuronyl transferase.

2. High content of unsaturated fatty acids in breast milk. The content of unsaturated free fatty acids in the breast milk of mothers of children with breast milk jaundice is increased, which inhibits liver glucuronyl transferase.

3. High activity of β-glucuronidase in breast milk The activity of β-glucuronidase in breast milk is much higher than that in cow's milk and formula milk, which re-decomposes the bound bilirubin, increases reabsorption in the small intestine, and increases entero-hepatic circulation. β-glucuronidase plays a major role in this process.

How to prevent breast milk jaundice?

To prevent breast milk jaundice in the early stage, first, the number of feedings should be increased for newborns 3-4 days after birth, but the amount each time should not be too much. Sucking stimulates intestinal peristalsis and reduces bilirubin reabsorption. If the amount of breast milk is insufficient, formula milk or other milk substitutes should be given appropriately to keep the baby from being hungry and prevent bile stasis. Second, early preventive phenobarbital can be used for newborns. Phenobarbital is an inducer of glucuronyl transferase activity, which can reduce bilirubin reabsorption in newborns, lower blood bilirubin levels, and prevent hyperbilirubinemia. Third, for children who have already developed breast milk jaundice, 1.5 grams of Smecta can be used without stopping breastfeeding, mixed with 10% glucose solution and fed once every 8 hours, which can promote the early disappearance of jaundice and ensure the healthy development of infants and young children.