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Neonatal jaundice and diet
G R Gourley1, B Kreamer, M Cohnen
1Department of Pediatrics, University of Wisconsin School of Medicine and Waisman Center on Mental Retardation and Human Development, Madison 53706, USA. gourley@waisman.wisc.edu
Objective:
To determine whether an earlier observation, that infants fed a casein-hydrolysate formula (Nutramigen) have lower neonatal jaundice levels than those fed standard formulas, would be repeated in a larger independent group of infants with more frequent measurements and more rigorous statistical analysis.
Design:
Newborn infants were fed human milk, a standard whey-predominant formula (Enfamil), or Nutramigen (n = 20 for each group) during the first 3 weeks of life. Transcutaneous jaundice index was measured daily for the first week of life and every 2 to 3 days thereafter, using a noninvasive jaundice meter. Linear regression models of the data were constructed, validated, and compared statistically.
Setting:
General community hospital with subsequent home visitation.
Participants:
Healthy, term newborn infants selected by convenience, based on time of birth.
Intervention:
Infants were exclusively fed human milk, Enfamil, or Nutramigen. Formulas were randomly assigned.
Main Outcome Measure:
Jaundice index, a transcutaneous measurement of jaundice.
Results:
The jaundice index differed significantly among the 3 groups. Paired comparisons showed that the jaundice index of the Nutramigen group was significantly lower than that of the Enfamil group (on days 6-16) and the human milk group (on days 3-20). The jaundice index of the Enfamil-fed group was significantly lower than that of the human milk group on days 13 to 19.
Conclusions:
Jaundice levels are lower in neonates fed Nutramigen rather than Enfamil and both these groups have lower jaundice levels than breast-fed infants.