Breast feeding practices and severe hyperbilirubinaemia

Area of Science:

• Neonatal Medicine
• Pediatrics
• Public Health

Background:

• Increased rates of breastfeeding correlate with a rise in severe hyperbilirubinaemia in infants.
• Severe hyperbilirubinaemia is defined as a serum bilirubin (SBR) level greater than or equal to 272 mumol/L.
• The study investigates the association between breastfeeding and unexplained severe hyperbilirubinaemia.

Purpose of the Study:

• To establish the association between early onset severe hyperbilirubinaemia and breastfeeding practices.
• To identify specific feeding practices that predict severe hyperbilirubinaemia in term infants.
• To inform clinical practice and public health recommendations regarding breastfeeding.

Main Methods:

• A case-control study comparing 125 term infants with severe hyperbilirubinaemia to 125 matched controls.
• Infants with severe hyperbilirubinaemia had peak SBR levels ≥ 272 mumol/L with no assigned cause.
• Data collected included maternal factors, infant weight loss, feeding frequency, and stool output.

Main Results:

• Severe hyperbilirubinaemia was associated with primiparous mothers, non-Caucasian ethnicity, maternal non-smoking, and oxytocin use.
• Univariate analysis showed less frequent breastfeeds, greater infant weight loss, and fewer stools were linked to severe hyperbilirubinaemia.
• Multivariate analysis identified maternal non-smoking, less frequent breastfeeding, less frequent stooling, and excessive infant weight loss as significant predictors.

Conclusions:

• Specific breastfeeding practices, including infrequent feeding and excessive infant weight loss, are significant predictors of severe hyperbilirubinaemia.
• Ongoing analysis of feeding practices is essential given the widespread promotion of breastfeeding.
• These findings highlight the need for careful monitoring and support for breastfeeding mothers to prevent severe hyperbilirubinaemia.