How to differentiate between breast milk jaundice and breastfeeding jaundice?

Understanding the Differences Between Breast Milk Jaundice and Breastfeeding Jaundice
Jaundice is a common condition in newborns, characterized by a yellowish discoloration of the skin and eyes due to elevated levels of bilirubin in the blood. While both breast milk jaundice and breastfeeding jaundice are associated with breastfeeding, they arise from different causes and have distinct implications for infant health.
Breastfeeding Jaundice: Insufficient Milk Intake
Breastfeeding jaundice, often referred to as “breastfeeding failure jaundice,” occurs when a newborn does not receive enough breast milk. This condition typically manifests within the first few days of life, as the infant struggles to get adequate nutrition. The insufficient intake leads to dehydration and inadequate caloric intake, which in turn causes an increase in bilirubin levels due to the breakdown of red blood cells that occurs naturally in newborns.
This type of jaundice is particularly concerning because it can lead to more severe complications, including bilirubin-induced encephalopathy, if not addressed promptly. Healthcare providers often recommend close monitoring of feeding patterns and may suggest supplementation with expressed breast milk or formula to ensure the baby is receiving enough nutrition.
Breast Milk Jaundice: A Different Mechanism
In contrast, breast milk jaundice arises from substances present in the mother’s milk that can inhibit the breakdown of bilirubin in the infant’s liver. This condition typically appears later, usually between four days to one week after birth, and can persist for several weeks. Unlike breastfeeding jaundice, breast milk jaundice is generally considered harmless and does not require the cessation of breastfeeding. In fact, continuing to breastfeed is encouraged, as the jaundice often resolves on its own without intervention.
The key distinction lies in the timing and underlying causes: breastfeeding jaundice is linked to inadequate milk intake, while breast milk jaundice is related to the composition of the milk itself. The latter is estimated to affect about 1 to 2% of newborns, making it a rarer occurrence compared to breastfeeding jaundice.
Clinical Implications and Management
Differentiating between these two types of jaundice is crucial for effective management. Healthcare providers assess the infant’s feeding habits, weight gain, and bilirubin levels to determine the appropriate course of action. In cases of breastfeeding jaundice, increasing the frequency of feedings or supplementing with formula may be necessary to ensure the baby is adequately nourished.
For breast milk jaundice, the focus shifts to monitoring bilirubin levels and ensuring the infant remains healthy while continuing breastfeeding. Parents are often reassured that this condition is typically benign and self-limiting.
Conclusion
In summary, while both breast milk jaundice and breastfeeding jaundice are associated with breastfeeding, they stem from different causes and require different management strategies. Understanding these distinctions is vital for parents and healthcare providers alike, ensuring that infants receive the appropriate care and support during this critical period of development.

What is the difference between the two types of jaundice?

Hepatic jaundice: Hepatic jaundice happens when your liver tissue becomes less effective at filtering out bilirubin from your blood. Post-hepatic jaundice: This type of jaundice happens when bilirubin filtered from the blood can’t drain properly into the bile ducts or digestive tract to be passed out of the body.

How do I know what type of jaundice I have?

Your provider can tell if you have jaundice by measuring the bilirubin levels in your blood and seeing whether it’s the type of bilirubin related to red blood cell breakdown (unconjugated) or liver injury (conjugated). They may also check for other signs of liver disease, including: Bruising.

What is the Kramer’s rule for jaundice?

Kramer’s Rule – Is a quick non-invasive method of assessing the degree of Jaundice. Blanch the skin in each of the five zones shown below, observe the colour of the blanched skin (will be yellow if jaundiced) – it gives you an indication of what the bilirubin level may be.

How do you diagnose breastfeeding jaundice?

A diagnosis of breast milk jaundice may be made if the consultant determines that your infant is latching onto the breast well and getting enough milk. Your doctor will then use a blood test to confirm the diagnosis. This test will measure the amount of bilirubin in your baby’s blood.

Is breastfeeding jaundice conjugated or unconjugated?

Breastmilk jaundice is a normal and regularly occurring increase in serum unconjugated bilirubin, which begins at the end of the first week of life and may continue for several weeks and even months thereafter in healthy, thriving infants.

How can you tell the difference between conjugated and unconjugated bilirubin?

The conjugated fraction reacts directly with Ehrlich’s diazo reagent and is thus called direct bilirubin. The unconjugated bilirubin requires the addition of alcohol to develop color reaction. It is also known as indirect bilirubin. Total bilirubin is the summation of the two fractions.

How long does breast milk jaundice last?

Breast milk jaundice most often occurs in the second or later weeks of life and can continue for several weeks. The exact mechanism leading to breast milk jaundice is unknown. Some believe that substances in the mother’s milk may inhibit the ability of the infant’s liver to process bilirubin.

What is the difference between breastfeeding jaundice and breast milk jaundice?

In sum, breastfeeding jaundice occurs when a baby is not getting enough breast milk, leading to increased bilirubin levels. On the other hand, breast milk jaundice occurs when certain substances in the mother’s milk may slow down the breakdown of bilirubin in the baby’s body.

What does jaundice baby poop look like?

Unconjugated or indirect bilirubin: This pigment is increased mostly in infants with neonatal jaundice. It is the bilirubin associated with normal destruction of older red blood cells. This is called physiologic jaundice. The baby’s urine is usually light yellow and the stool color is mustard yellow or darker.

Do you stop breastfeeding in breast milk jaundice?

In most cases, breastfeeding can, and should, continue. More feedings can reduce the risk of jaundice. Breast milk jaundice most often occurs in the second or later weeks of life and can continue for several weeks.