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Neonatal jaundice is more common and lasts longer in breast-fed infants compared to formula-fed infants. This study highlights differences in hyperbilirubinemia based on infant feeding type.
Area of Science:
- Neonatalogy
- Pediatrics
- Public Health
Background:
- Neonatal jaundice is a common condition in newborns.
- Infant feeding practices, including breastfeeding and formula feeding, may influence jaundice development and duration.
Purpose of the Study:
- To investigate the relationship between infant feeding type and the occurrence and natural history of neonatal jaundice in term newborn infants.
- To compare jaundice progression in breast-fed versus formula-fed infants.
Main Methods:
- Retrospective chart review of 124 records.
- Prospective cohort study of 140 term newborn infants using a transcutaneous jaundice meter.
- Follow-up for 3 weeks, with data collection at predetermined intervals.
Main Results:
- Jaundice was recognized more often in breast-fed infants.
- Peak jaundice meter readings were higher and lasted longer in breast-fed infants compared to formula-fed infants.
- Formula-fed infants' readings normalized by day 8, while breast-fed infants' readings remained elevated at day 21.
- Black infants showed higher readings than white infants due to skin pigmentation, but disease course was similar.
- A bimodal distribution of jaundice was observed in white infants, with approximately one-fourth of breast-fed infants experiencing higher bilirubin levels.
Conclusions:
- Human milk feeding is associated with more prolonged hyperbilirubinemia than formula feeding in normal term infants.
- Feeding type is a significant factor in the management and monitoring of neonatal jaundice.
Abstract:
The relationship between infant feeding type and the occurrence and natural history of neonatal jaundice in term newborn infants has been studied. A retrospective chart review of 124 records confirmed earlier reports indicating that jaundice is recognized more often in breast-fed than in formula-fed infants. A prospective cohort study of 140 term newborn infants was conducted using the Minolta Air-Shields transcutaneous jaundice meter. For 3 weeks, 115 white infants and 25 black infants were followed at predetermined intervals. The peak jaundice meter readings were higher and the elevated levels lasted longer in breast-fed than in formula-fed infants. Formula-fed infants' readings returned to base-line levels in eight days whereas the readings were still elevated in breast-fed infants when the study ended on the 21st day. Black infants had higher transcutaneous readings than white infants due to their deeper skin pigmentation, but otherwise they followed a course identical with that of the white babies. The distribution of jaundice in the white infants was bimodal; in approximately one fourth of the breast-fed infants, the jaundice meter readings reached levels corresponding to bilirubin values greater than 13 mg/dL whereas the remaining three fourths followed a pattern similar to that of the formula-fed infants. It can be concluded that human milk feeding is associated with more prolonged hyperbilirubinemia than formula-feeding in normal term infants.