In plain words
Breast milk jaundice is yellowing of the skin in a breastfed baby that is linked to substances in breast milk. The milk can slow the way the baby's liver handles , so the level stays high for longer. It is usually seen after the first few days, once milk is flowing well. The baby may be feeding well and gaining weight. This differs from caused by too little milk, where the baby is not getting enough to eat and feeding needs to change. The two can look alike. Clinicians tell them apart by checking feeding, weight, and stool, and by measuring bilirubin over time. Clinicians generally continue breastfeeding with close follow-up.
The deeper version
Breast milk jaundice is a form of late-onset neonatal attributed to an enterohepatic mechanism in which milk factors, including beta-glucuronidase, increase the deconjugation and reabsorption of bilirubin in the gut. It is distinguished from , which reflects low and dehydration. It is usually diagnosed by exclusion, with a feeding assessment, weight trajectory, and bilirubin measurement. The AAP's 2022 guideline (Kemper and colleagues, Pediatrics, 2022) sets thresholds relative to age and risk, and it favors continuing breastfeeding during evaluation. may address suboptimal intake without displacing breastfeeding. The relative contributions of milk factors and infant intake remain debated, and trial data are limited.
Where it comes up
- Newborn jaundiceBaby Basics
- Feeding a baby with jaundiceFeeding Your Baby
- Is my baby getting enough?Feeding Your Baby
- Diaper counts and what newborn poop looks likeBaby Basics
- Growth spurts and feeding changesFeeding Your Baby
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Sources
- Kemper AR and colleagues, American Academy of Pediatrics — Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant, 2022
- Lawrence RA, Lawrence RM — Breastfeeding: A Guide for the Medical Profession, 8th edition, 2016