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Breast milk jaundice is caused by an increased concentration of β-glucuronidase in breast milk, which increases bilirubin deconjugation and reabsorption of bilirubin, leading to persistence of physiologic jaundice with unconjugated hyperbilirubinemia. Onset of breast milk jaundice is within 2 weeks after birth and lasts for 4–13 weeks.
Diagnosis of hyperbilirubinemia depends on physical examination, urinalysis, serum tests, medical history and imaging to identify the cause. Genetic diseases, alcohol, pregnancy and hepatitis viruses affect the likelihood of hyperbilirubinemia. Causes of hyperbilirubinemia mainly arise from the liver.
Whereas breastfeeding jaundice is a mechanical problem, breast milk jaundice is a biochemical occurrence and the higher bilirubin possibly acts as an antioxidant. Breast milk jaundice occurs later in the newborn period, with the bilirubin level usually peaking in the sixth to 14th days of life.
774 Other perinatal jaundice. 774.2 Jaundice, newborn, prematurity; 774.3 Jaundice, newborn, unspec. 774.3 Lucey-Driscoll syndrome. 774.39 Jaundice, newborn, breast milk; 775 Endocrine and metabolic disturbances specific to the fetus and newborn. 775.0 Infant of diabetic mother syndrome; 775.4 Hypocalcemia; 775.6 Hypoglycemia, neonatal
Hereditary hyperbilirubinemia refers to a group of conditions where levels of bilirubin, a byproduct of red blood cell metabolism, are elevated in the blood due to a genetic cause. [1] Various mutations of enzymes in the liver cells, which breakdown bilirubin, cause varying elevated levels of bilirubin in the blood. [ 2 ]
Primary lactation failure, a cause of low milk supply in breastfeeding mothers; Cessation of breastfeeding before the mother had planned to stop, usually as a result of breastfeeding difficulties; Low milk supply in general; Inability to establish breastfeeding, which may be caused by delayed onset of lactation
The causes of breast milk jaundice include variations in bilirubin metabolism, genetic variations, and variations in breastmilk, including the harmless and helpful germs found naturally on the surface of the skin and in the breastmilk. [40] Breast milk jaundice is usually not a reason to stop nursing. [121]
Crigler–Najjar syndrome is a rare inherited disorder affecting the metabolism of bilirubin, a chemical formed from the breakdown of the heme in red blood cells. The disorder results in a form of nonhemolytic jaundice, which results in high levels of unconjugated bilirubin and often leads to brain damage in infants.