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Beta-glucuronidase and hyperbilirubinemia in breast-fed versus formula-fed babies
M S el-Kholy1, H Y Halim, A H Marzouk
1Pediatric Department, Ain Shams Faculty of Medicine.
Insights
Breast milk contains beta-glucuronidase, an enzyme linked to higher infant bilirubin levels. This enzyme in breast milk may contribute to neonatal hyperbilirubinemia in breast-fed babies.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatrics
Background:
- Neonatal hyperbilirubinemia is a common condition in newborns.
- Breast milk is known to contain various enzymes that can affect infant physiology.
- The role of specific milk enzymes in neonatal jaundice requires further elucidation.
Purpose of the Study:
- To investigate the presence and activity of beta-glucuronidase in breast milk and formula.
- To examine the correlation between beta-glucuronidase levels and indirect bilirubin concentrations in breast-fed and formula-fed infants.
- To determine the potential role of breast milk beta-glucuronidase in neonatal hyperbilirubinemia.
Main Methods:
- Analysis of beta-glucuronidase enzyme activity in breast milk, formula, and infant serum samples.
- Measurement of serum indirect bilirubin levels in infants.
- Statistical correlation analysis between enzyme activity and bilirubin levels.
Main Results:
- Significantly higher serum indirect bilirubin levels were observed in breast-fed infants compared to formula-fed infants.
- Considerable beta-glucuronidase activity was found in human milk, but negligible activity in formula.
- A significant correlation was found between serum beta-glucuronidase levels and serum indirect bilirubin in both feeding groups, and specifically between breast milk beta-glucuronidase and infant bilirubin.
Conclusions:
- Breast milk beta-glucuronidase activity is significantly higher than in formula.
- Breast milk beta-glucuronidase appears to facilitate bilirubin reabsorption, contributing to neonatal hyperbilirubinemia in breast-fed infants.
- This enzyme is a potential factor in the development of jaundice in newborns receiving breast milk.
Abstract:
Breast milk and formula milk and the corresponding serum samples from 20 breast-fed babies, 20 formula-fed babies, and their mothers were examined at 3 days of age for beta-glucuronidase enzyme. Serum indirect bilirubin levels were also examined for all the infants. Serum indirect bilirubin concentrations were significantly higher (p < 0.001) in breast-fed (4.87 +/- 2.4 mg/dl) than in formula-fed infants (1.04 +/- 0.5 mg/dl). beta-glucuronidase activity in formula milk was negligible, while that in human milk was considerable (468.26 +/- 220.8 Sigma units/ml) and was correlated (p < 0.05) with that in the serum of the breast-fed (66.13 +/- 18.1 Sigma units/ml) than in formula fed infants (52.08 +/- 11.9 Sigma units/ml) and a significant (p < 0.05) correlation was found between its serum level and serum indirect bilirubin in both breast and formula fed infants. Also in breast-fed infants serum bilirubin concentrations were related to beta-glucuronidase activity in breast milk (p < 0.05): Breast milk beta-glucuronidase--by facilitating intestinal reabsorption of bilirubin--seems to be an important factor in the neonatal hyperbilirubinemia of breast-fed babies.