Breastmilk Jaundice

Breastmilk Jaundice (BMJ) is different from the common Breastfeeding Jaundice (BFJ).

In Breastfeeding Jaundice, pediatrician or parent will start seeing the yellowness 3rd or 4th day the baby is born.  Usually that may mean the baby is not getting enough milk or nutrient to get rid of the bilirubin.  With more breastfeeding (BF), the BFJ will go away.  For those who worry about low milk supply, formula supplement will help in making the BFJ go away also.

To be safe, a blood sample is taken to see the jaundice level.  For a baby 3-4 days old, the serious jaundice level is set low, so many babies will get prescribed the biliblanket.  If you live in a big city, like I do, it’s simple.  The pediatrician fax in an order for the biliblanket and the biliblanket gets delivered to home.  When the pediatrician says it’s no longer needed, some one will come to pick up the biliblanket.

How about Breastmilk Jaundice?  The yellowness shows up at around 5th day and peaks at around 2 weeks old.  Jaundice level is closely monitored by weekly blood sample.

Biliblanket hardly helps because no matter how the biliblanket convert the bilirubin into waste-form, the enzyme associated with BMJ will convert it back into bilirubin form.  If a biliblanket is used, the jaundice level may only lowered by very, very little then will bounce back up when the biliblanket is no longer used.

The same with sunlight.

So, what are some solutions to BFJ?

(1) Exclusive formula feeding.  Of course this method helps because the breastmilk that causes BMJ no longer plays a role

(2) Exclusive formula feeding for 48-72 hours only.  In most cases, this solution works.  They think the formula feeding seems to break the cycle of the enzyme-digestion-bilirubin relationship.  Maybe the bacteria/enzyme in the large intestine that feeds on breastmilk got weaken/killed during the 48-72 hour period?

(3) Do nothing and continue to BF.  Since there hasn’t been any cases where BMJ causes any serious problem except for just higher level of jaundice, there’s no really alarm to BMJ.  Just continue to BF and the jaundice level will eventually drop at around 6-12 weeks.  Of course, weekly monitoring is highly recommended.  Poor baby.  =(

For the blood draw, some advices would be: keep baby’s feet warm for a period of time (maybe even 30 min or an hour) before the heel prick so that the blood will flow better as the technician SQUEEZE that little foot to get blood out.  I’ve read about sugar water/breastmilk helps with pain relief as well; maybe the distraction and comfort?

BMJ and BFJ most commonly occur among Asians.

By the way, method #2 may not work if baby refuses to take the bottle or drink the formula.  If that happens, just go method #3.  =)  Have fun!