What are the other Names for this Condition? (Also known as/Synonyms)

• BMJ (Breast Milk Jaundice)
• Hyperbilirubinemia

What is Breast Milk Jaundice? (Definition/Background Information)

• There are several types of jaundice that affect a newborn child
• Breast Milk Jaundice (BMJ) is a common disorder affecting healthy infants shortly after birth, caused by certain substances present in breast milk. Yellowing of the eyes and skin is noticed
• It is rarely severe or serious, and the condition is easily managed. However, preterm, low-birth weight infants, or babies who suffer other illnesses, may have a risk of developing certain medical complications

Who gets Breast Milk Jaundice? (Age and Sex Distribution)

• The onset of Breast Milk Jaundice is normally within 4-7 days after birth, and continues for 3-12 weeks
• The incidence of BMJ can be high, with 1 in 40 babies being affected
• Both male and female babies are equally affected
• There seems to be an increased incidence of the condition amongst Asian (Chinese, Korean, and Japanese) and Native American babies

What are the Risk Factors for Breast Milk Jaundice? (Predisposing Factors)

Following are the risk factors for Breast Milk Jaundice:

• BMJ runs in the families, and children (siblings) born in families with a medical history of the condition may be at risk
• Breastfeeding babies on intravenous support (dextrose solution), may cause the condition to aggravate or may be increasingly prone to contract BMJ
• If the baby does not feed well, or if there is reduced milk production leading to a decreased milk intake, it could worsen the condition
• There are a host of naturally-occurring chemical substances, the presence or absence thereof from breast milk, could cause BMJ

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Breast Milk Jaundice? (Etiology)

• Red blood cells that get continuously discarded are processed by the liver, resulting in the formation of a yellowish pigment bilirubin. Under normal conditions, this is excreted out of the body system
• However, sometimes certain components of breast milk prevent the removal of bilirubin from the body, which builds up in the body. This condition is called Breast Milk Jaundice
• The breast milk substances that cause BMJ include lipoprotein lipase, glucuronidase, and other genetically modified/altered components
• The exact mechanism how certain breast milk components cause Breast Milk Jaundice, is unknown

What are the Signs and Symptoms of Breast Milk Jaundice?

Signs and symptoms of Breast Milk Jaundice are:

• Gradual yellowing of eyes and skin (face) initially, which slowly spreads to the entire body. The skin tone and vitality is not lost though
• Baby may be sleepy, but otherwise muscle and neuro-reflexes appear normal
• Some weight loss is observed

How is Breast Milk Jaundice Diagnosed?

There are several types of baby jaundice. Thus, an accurate evaluation and assessment is important. Diagnostic tests for detecting Breast Milk Jaundice, performed on the newborn child include:

• Physical exam with evaluation of medical history; evaluation of both the child and mother
• Blood analysis: Total blood count, peripheral smear blood test, blood typing, evaluation of serum bilirubin amount, count of old RBCs (reticulocytes), check for certain protein levels, platelet count
• Urine test and culture
• A differential diagnosis should be considered to eliminate other jaundice types

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Breast Milk Jaundice?

Breast Milk Jaundice complications may develop if the infant is born preterm, or is severely malnourished, or does not get the correct treatment. These may include:

• Liver, other organs being affected
• Serious brain, neurological abnormality due to a severe state of jaundice, known as kernicterus
• Sepsis; due to underlying infections

How is Breast Milk Jaundice Treated?

The treatment measures recommended for Breast Milk Jaundice are based on certain parameters of the infant, which include serum bilirubin level (and its rate of increase), baby’s age (in days), condition at birth, and baby weight.

• If bilirubin levels are low, then a healthy infant may be monitored closely, until the child’s condition improves. No specific treatment is necessary
• Increasing breastfeeding incidences may decrease bilirubin levels. Education about proper breastfeeding techniques may help in ensuring that the baby suckles well. The latching technique should be corrected, if required
• Breast milk may be supplemented by formulaic preparations, or through intravenous fluid administration. However, both these measures are prescribed, only when it is really necessary
• Phototherapy (or light treatment) is used to help the body break-down bilirubin. The baby’s skin is exposed to a special blue light (light of a particular wavelength) for certain periods of time

How can Breast Milk Jaundice be Prevented?

• Breast Milk Jaundice is a common disorder that manifests itself shortly after birth; it cannot be prevented
• It is not a serious condition, and an increased nursing (breastfeeding) of the infant can help the child speedily recover, from the illness

What is the Prognosis of Breast Milk Jaundice? (Outcomes/Resolutions)

• Breastfeeding Jaundice has excellent prognosis, in a majority of the cases
• Some babies with underlying medical conditions may require additional treatment measures, if any complications develop

Additional and Relevant Useful Information for Breast Milk Jaundice:

• There are basically 3 types of jaundice that affect the newborn babies: Physiologic Jaundice, Breast Milk Jaundice, and Breastfeeding Jaundice
• It has to be ensured that the condition of the baby is rightly assessed and diagnosed; in order to correlate it with the right treatment mode