Jaundice in newborn after breastfeeding

Introduction Breast-fed infants develop jaundice 4 to 7 days after birth, peaking at 2 to 4 weeks (serum bilirubin can exceed 256.6-342.0 mol/L), generally in good condition without hemolysis or anemia. Jaundice usually lasts for 3 to 4 weeks. The second month gradually subsided, and a few can be extended to 10 weeks before retreating. If breast milk is stopped for 3 to 4 days during the period, the jaundice is obviously reduced, and the bilirubin is reduced by 50%. If breastfeeding is used again, the jaundice does not necessarily appear again, and even if it appears, it will not reach the original level.

Cause

Since the breast milk contains more lipase and -glucuronosidase, the former increases the amount of unsaturated fatty acids in the milk, thereby inhibiting the activity of hepatic glucuronyltransferase; the latter can decompose the ester bond of bilirubin glucuronosole, The combined binding of bilirubin to unconjugated bilirubin is easily reabsorbed in the small intestine, thereby increasing the intestinal-hepatic circulation, resulting in an increase in unbound bilirubin in the blood and jaundice.

an examination

Related inspection

Erythrocyte serum total bilirubin xanthine examination erythrocyte serum total bilirubin red blood cell diameter (MCD) alpha-fetoprotein variant (AFPV)

After birth, breastfeeding has no other reasons for hyperbilirubinemia, bilirubin often reaches 256.5 ~ mol / L (15 ~ 20mg / dl) newborns are generally good, good milk, normal growth and development. Astragalus can last from 3 weeks to 3 months.

Elevated bilirubin: Bilirubin is a pigment produced by hemoglobin in red blood cells. Red blood cells have a fixed life span and are destroyed daily. At this time, hemoglobin is decomposed into heme and heme. Then the action of the heme-enzyme will turn into bilirubin, and the heme will be reconstituted into tissue proteins.

Normal value: total bilirubin: 1.7 to 17.1 mol/L; direct bilirubin: 0 to 3.42 mol/L; indirect bilirubin: 1.7 to 13.68 mol/L.

Differential diagnosis

Astragalus is common in newborns at any other age. Its cause is special and complex. It has both physiological jaundice and pathological jaundice, as well as breast milk jaundice. These situations should be treated differently and handled.

Pathological jaundice: If the child develops jaundice or jaundice within 24 hours after birth, it will develop too fast, lasting for a long time, even accompanied by anemia, abnormal body temperature, poor feeding, vomiting, and abnormal color of urine and urine. Some are yellow sputum that has subsided or reduced and then reappeared and aggravated, mostly pathological jaundice. Common causes of pathological jaundice are neonatal hemolytic disease, neonatal infection, biliary malformation, and neonatal hepatitis.

Physiological jaundice: The starting time of jaundice is 2-3 days after birth, lasting for about 1 week, mainly with unbound bilirubin, hemolytic and hepatocellular, no clinical symptoms.

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