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A controlled, randomized, double-blind trial of prophylaxis against jaundice among breastfed newborns

Glenn R Gourley1, Zhanhai Li, Bill L Kreamer

  • 1Department of Pediatrics, Oregon Health and Science University, Portland, Oregon 97239-2998, USA. gourleyg@ohsu.edu

Pediatrics
|August 3, 2005
PubMed

Insights

Beta-glucuronidase inhibitors like L-aspartic acid and enzymatically hydrolyzed casein (EHC) reduced newborn jaundice in breastfed infants. These treatments increased fecal bilirubin excretion without negatively impacting breastfeeding.

Area of Science:

  • Neonatal care
  • Pediatric gastroenterology
  • Biochemistry

Background:

  • Neonatal jaundice is a common condition, particularly in breastfed infants.
  • Breast milk contains beta-glucuronidase, which can contribute to elevated bilirubin levels.
  • Effective interventions are needed to manage jaundice without compromising breastfeeding.

Purpose of the Study:

  • To investigate the efficacy of beta-glucuronidase inhibitors in reducing neonatal jaundice in breastfed newborns.
  • To assess the impact of these inhibitors on fecal bilirubin excretion.
  • To determine if treatment affects the breastfeeding experience.

Main Methods:

  • Sixty-four breastfed newborns were randomized into four groups: control, L-aspartic acid, enzymatically hydrolyzed casein (EHC), or whey/casein (W/C).
  • Interventions were administered for the first week of life.
  • Transcutaneous bilirubin levels were measured daily, and fecal bile pigments were analyzed using high-performance liquid chromatography.

Main Results:

  • L-aspartic acid, EHC, and W/C groups showed significantly lower transcutaneous bilirubin levels compared to the control group.
  • Fecal bile pigment excretion was significantly higher in the L-aspartic acid group.
  • No significant differences were observed in body weight, feeding weights, or maternal ratings across groups.

Conclusions:

  • L-aspartic acid and EHC effectively reduce neonatal jaundice by increasing fecal bilirubin excretion.
  • These interventions do not adversely affect the breastfeeding experience.
  • The W/C group's reduced jaundice suggests a potential alternative mechanism for jaundice reduction.
Abstract

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