Breastfeeding and Jaundice

Infant jaundice is a condition that occurs when a baby has elevated bilirubin levels, causing their skin and eyes to have a yellowish tint. Jaundice in newborns is extremely common, with 60% of full-term babies and 80% of preterm babies having the condition during the first week of life.

In most cases, jaundice does not present any complications and resolves itself over time. Jaundice is often still present when a mother first starts breastfeeding, and usually, the consistent supply of milk helps lower the baby’s bilirubin levels.

Sometimes, breastfed babies have difficulty getting rid of jaundice. This can lead to what’s known as breastfeeding jaundice or breastmilk jaundice. These are two separate conditions with different causes and treatment.

Fortunately, there is not a major problem for most children and mothers can still breastfeed their child even if their child develops jaundice.

What is Jaundice?

Infant jaundice stems from excessive bilirubin in the blood. Bilirubin is a substance made during the normal breakdown of red blood cells and is passed through the liver before being excreted from the body. The primary symptoms of jaundice are yellowing of the skin and eyes.

When you are the parent of a newborn, everything is a big deal. But jaundice is a normal occurrence in newborns. It is particularly prevelent in preterm infants who have underdeveloped organs. There are several reasons as to why a baby is born with jaundice, including:

• The newborn has a higher rate of bilirubin production due to a shorter lifespan of red blood cells and higher red blood cell concentration
• A newborn (especially preterm newborns) has an underdeveloped liver with limited function, which leads to slower metabolism of bilirubin
• Newborns who have delayed meconium, which increases the reabsorption of bilirubin in the intestines.

For the wide majority of cases, jaundice is quickly resolved within the first few weeks of life. There is usually no specific treatment for mild jaundice besides careful monitoring of symptoms and providing adequate nutrition.

What is the Difference Between Breastfeeding Jaundice and Breast Milk Jaundice?

There are two types of jaundice in breastfed babies: (1) breastfeeding jaundice; and (2) breast milk jaundice. They may sound similar, but they have different causes and treatment.

1. Breastfeeding Jaundice

Breastfeeding jaundice usually occurs in the first week of life while the baby and mother are in the early stages of learning how to breastfeed. Breastfeeding jaundice is the result of the baby not receiving enough milk to lower their bilirubin levels. This causes the bilirubin to be reabsorbed into the intestines and keep the levels elevated which triggers jaundice.

Breastfeeding jaundice can be caused by difficulty breastfeeding, improper latching, or is supplemented with other substitutes that interfere with breastfeeding.

2. Breast Milk Jaundice

This is newborn jaundice that lasts longer than traditional jaundice, usually lasting several weeks after birth. It can occur in healthy, full-term newborns. The cause of breast milk jaundice is currently unknown, but doctors believe it is linked to some type of substance in the breast milk that inhibits the liver’s ability to break down and process bilirubin. This type of jaundice has been known to run in families.

Phototherapy and temporary supplementation with donor human milk or infant formula are common treatments. In rare cases, breastfeeding may need to be temporarily interrupted.

How Long Does it Take for Jaundice to go Away in Breastfed Babies?

The vast majority of newborn jaundice goes away completely by the time the baby is 2-3 weeks old. For babies that are breast fed, however, it may take a bit longer for their jaundice to clear up and go away. This is because breast fed babies often do not get as much milk, especially in the first few days. The other reason is that certain enzymes and proteins in the mother’s breast milk may prevent the liver from breaking down free bilirubin in the system.

Is Breastmilk or Formula Better for Jaundice?

For a number of reasons, breastmilk is widely considered to be better and healthier for babies. However, this is not necessarily true for infant jaundice. Infant jaundice is more common in breastfed babies because their metabolisms tend to start a little slower. Babies on formula are less likely to get jaundice and when they do get jaundiced it tends to go away faster compared to breast fed babies.

Treatment for Breastfeeding and Breast Milk Jaundice

There are some general recommendations for mothers to help reduce their child’s bilirubin levels. If their bilirubin levels are below 20 milligrams, some of these treatments may be useful.

• Increase daily feedings for your baby. It’s recommended for babies with jaundice to feed 8-12 times a day to help the baby produce more bowel movements, which excretes the bilirubin.
• Contact a lactation consultant to have them assist you in the proper technique of breastfeeding. Lactation consultants can help a baby latch onto the breast properly, which gives them better access to milk.
• There is usually no need to stop breastfeeding if jaundice occurs. In most cases, doctors encourage mothers to consistently feed their baby. If bilirubin levels reach above 20 milligrams, it may be necessary to use phototherapy and stop breastfeeding for 24 hours.

There are also other things you want to avoid your newborn has jaundice. You should not try supplementing with sugar water, which can worsen jaundice by interfering with the breast milk. Sugar water is not effective in reducing bilirubin levels. You should also not stop breastfeeding unless your doctor advises you. Breastfeeding is the primary method of getting rid of jaundice.

In general, jaundice in a newborn is not something to worry over. It’s a highly treatable condition that can be managed with the proper methods and careful monitoring. Even if your baby is having difficulty lowering their bilirubin levels, doctors are equipped with the necessary treatment and tools to rid get rid of the condition.