- yellow discoloration of the skin and whites of eyes
- acting particularly sleepy or listless
- poor weight gain
- high pitched crying
Jaundice, characterized by yellow-tinged skin and eyes, is common in the first week of your newborn’s life. Occasionally jaundice will persist or re-emerge up to the sixth week in healthy, breastfed infants.
Breast milk jaundice is rare, affecting only 0.5 to 2.4 percent of infants, and is not dangerous. Persistent jaundice in infants that struggle with breastfeeding is not the same as breast milk jaundice, which only occurs in infants that consume adequate levels of breast milk.
Any signs of jaundice in your infant should be checked by your pediatrician to make sure that there is no other, more serious cause underlying the problem. Severe, untreated jaundice can cause your baby to suffer permanent brain damage and/or hearing loss.
Infants are born with elevated levels of red blood cells. As their body begins to remove the old red blood cells immediately after birth, a yellow pigment called bilirubin is created. Typically, the yellow skin discoloration caused by bilirubin fades on its own as the maturing liver breaks the pigment down and it is removed in your infant’s urine and stool.
Breastfed infants who fail to consume enough milk may suffer prolonged jaundice, as the bilirubin stalls in the system due to inadequate nutrition. The reasons why healthy infants who adapt well to breastfeeding become jaundiced remain unknown. It is speculated that substances in breast milk may block the proteins in the liver responsible for breaking down bilirubin.
Any breastfed newborn may suffer breast milk jaundice. Since a definitive cause has not been identified, few risk factors are associated with the condition. Breast milk jaundice may be genetic, so a family history of jaundice in breastfed infants may indicate increased risk.
Your breastfed infant who is latching onto the breast and feeding well may shows signs of jaundice past the first week of life in the following ways:
Lactation specialists may observe feedings to ensure your baby is latching properly and the mother’s milk supply is sufficient. Breastfeeding jaundice is more typical than breast milk jaundice, and misdiagnosis is common. If your infant is consuming enough milk and jaundice still persists, physicians will usually administer a blood test to measure bilirubin levels. The higher the level of bilirubin, the more severe the jaundice.
You will often continue to breastfeed your child as usual. Jaundice is a temporary condition that shouldn’t interfere with the benefits of breast milk. Mild jaundice may be monitored at home with the expectation that it will dissipate over time as the child’s liver becomes more efficient and he or she continues to consume recommended quantities of milk.
Severe jaundice is often treated with phototherapy lights, either in the hospital or at home. Your baby is kept under the lights while wearing protective eyeglasses for one to two days. The lights alter the structure of bilirubin molecules, which allows them to be quickly excreted in the urine and stool.
Most cases of breast milk jaundice cannot be anticipated or prevented. Any concern you may have about breast milk jaundice should not convince you to discontinue breastfeeding. You should only stop breastfeeding if instructed by your pediatrician. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life. Infants should feed eight to 12 times per day in the weeks immediately following birth. (AAP)
If the components of breast milk are the sole reason for jaundice, the condition should easily be resolved, either with continued feeding and monitoring or light therapy. Jaundice that persists past the sixth week of life, despite therapy efforts, may be caused by underlying medical conditions and require more aggressive treatment.