What is Breast Milk Jaundice? A Guide For Parents

Breast milk jaundice is a common concern for new parents, often causing confusion and worry. The condition, common among breast-fed babies, usually appears after one week of life. Knowing about breast milk jaundice – the causes, symptoms, and treatment is key to keeping your baby healthy and alleviating your anxiety during this vital developmental period.

Understanding Neonatal Jaundice 

Neonatal jaundice causes the skin and eyes of the baby to become yellow from high levels of bilirubin, a substance formed during the normal breakdown of red blood cells. It’s not uncommon: about half of all full-term babies, and up to 80% of premature babies [ref], suffer from it. Jaundice usually develops within a few days of being born because the newborn’s liver is typically too young to digest bilirubin properly.

There are various forms of neonatal jaundice: physiological, a response to this prematurity, and pathological, which might be a sign of a malignancy. Breastfeeding jaundice develops in the first few days when the milk supply is low, and breast milk jaundice generally develops after the first week because breast milk contains a mixture of chemicals that alter the metabolism of bilirubin. Monitoring and treating jaundice is necessary to protect the baby and avoid complications.

What is Breast Milk Jaundice? 

Breast milk jaundice is a particular type of jaundice that occurs in breastfed babies and generally appears after the first week of life. It’s triggered by molecules in breast milk that stop the liver from digesting bilirubin, the waste product of red blood cell breakdown. In the early days of a newborn’s life, breastfeeding has a significant impact on the degree of jaundice. [ref]

Breast milk jaundice, unlike other types of jaundice, is generally harmless and goes away naturally when the baby’s liver develops.

How Does It Differ From Breastfeeding Jaundice? 

Breastfeeding jaundice, on the other hand, arises in the first few days after birth due to inadequate breastfeeding or insufficient milk intake, leading to dehydration and elevated bilirubin levels. This type of jaundice can easily be prevented with better feeding techniques.

Causes of Breast Milk Jaundice 

The precise cause of breast milk jaundice is still unknown. [ref] But, many experts believe that a substance in breast milk prevents the liver from absorbing and appropriately breaking down bilirubin, which leads to breast milk jaundice. 

Let’s look at the factors that might increase the chances of a newborn developing breast milk jaundice. 

Preterm babies are more likely to develop this type of jaundice because their livers are not fully developed yet to process and eliminate bilirubin. 

Not getting enough breast milk in the first few days of life can also lead to this jaundice since it can contribute to overall high bilirubin levels and dehydration. 

Some babies have a genetic predisposition that affects their ability to metabolize bilirubin, making them more susceptible to jaundice. 

If the baby is born with unnaturally high red blood cells, it can result in high bilirubin levels. 

The blood types of certain children don’t match with their mothers. In this case, the mother’s body produces antibodies that attack the baby’s red blood cells. 

Symptoms of Breast Milk Jaundice 

The first and most conspicuous appearance of jaundice is the yellowing of skin and eyes. This occurs after the first week of life, and the coloration becomes more noticeable in the second week. After the face and eyes, a yellow tone might appear in the chest, abdomen, and then the legs. If the baby has constantly high bilirubin levels, insomnia and sloppiness can kick in as well. 

Sometimes, parents cannot spot the yellowing of the skin due to the baby’s dark skin color. If this happens, push down a bit on your baby’s forehead or nose with your finger. If your baby has jaundice, you will see the yellow tone on their skin as you lift your finger.

When to Consult a Doctor 

Parents should see a doctor if they observe any of the following symptoms in their baby:

Jaundice onset within a day - If the baby’s skin and eyes turn yellow right just a few hours after they were born, it may indicate a serious issue, demanding a doctor’s intervention. 

Inability to stay awake or poor feeding - If the baby seems excessively drowsy, is hard to wake for feedings, or exhibits poor feeding behavior, it can be a sign of high bilirubin levels. 

Signs of dehydration - Dry mouth, decreased wetness of diapers, or a submerged fontanelle (soft spot on the top of your baby’s head) may signal the need for medical attention.  

Diagnosis 

Breast milk jaundice can be diagnosed based on a combination of physical exams and laboratory tests: 

Physical examination - A pediatrician will check the baby’s skin and eyes for signs of jaundice.

Bilirubin test - A blood test measures the bilirubin levels to determine their severity and whether they fall within a safe range.

Assessment of feeding habits - The physician might ask about the baby’s feeding routine to rule out breastfeeding jaundice due to a lack of milk supply.

Exclusion of other conditions - Additional tests may be conducted to rule out other causes of jaundice, such as hemolytic disease or liver dysfunction.

Management and Treatment 

Breast milk jaundice is a harmless condition that usually goes away by itself and, in most cases, does not need medical intervention. However, regular monitoring and management are recommended to ensure your baby’s health. Here are the key approaches for managing and treating breast milk jaundice: 

Continued breastfeeding - This helps prevent dehydration in newborns. Doctors generally recommend continuing breastfeeding as it provides essential nutrients and antibodies that support the baby’s healthy growth. 

Phototherapy - If your baby’s bilirubin levels become excessively high, doctors might ask you to go for phototherapy. This treatment involves exposing the baby to a light that helps in the breakdown of bilirubin. Phototherapy effectively reduces bilirubin levels in breastfed newborns. [ref]  

Exchange blood transfusion - It is needed only in the ‘rarest of rare’ cases when bilirubin levels go off the chart. The process involves replacing the baby’s blood with a transfusion. 

Tips For Parents 

Parents can effectively manage breast milk jaundice by staying vigilant and informed. Here are a few tips for new parents: 

Observe your baby’s skin color - Check your baby’s skin and the whites of their eyes regularly for any signs of jaundice. 

Keep track of feeding - Ensure your baby is hydrated and well-nourished. Aim for 8-12 feedings every 24 hours. 

Be informed - Educate yourself about breast milk jaundice, its symptoms, and its typical course. 

Keep your pediatrician in the loop - If you have any questions about your baby’s health, raise concerns with your pediatrician.  

Stay calm and maintain a healthy environment - Don’t panic about this condition as it resolves on its own in most cases. 

Summing Up 

You need not worry about your baby getting diagnosed with breast milk jaundice, because it’s a typically benign condition. Although, you must understand its ABCs to support your baby’s growth during this vital development phase. 

FAQs

Does breast milk jaundice mean I should stop breastfeeding?

Breast milk jaundice does not necessarily mean you should stop breastfeeding altogether. Breastfeeding has lots of other health benefits for your baby. Breast milk jaundice does not indicate low nutrition. On rare occasions where the baby’s bilirubin readings are very high, the doctor might prescribe some intermittent formula supplementation, but this usually doesn’t need to be done.

How long does breast milk jaundice last?

Breast milk jaundice lasts 3 to 12 weeks but varies with each baby. It usually goes away as your baby’s liver develops and becomes more capable of absorbing bilirubin. Breast milk jaundice is relatively long-lasting but usually harmless and doesn’t require treatment. You can have regular screenings and know it’s getting better.

Can breast milk jaundice recur in children?

Yes, breast milk jaundice can recur in subsequent children if you breastfeed them. This is because the disease is related to components in your breast milk that influence bilirubin metabolism.

Can breast milk jaundice affect my baby’s long-term health?

Breast milk jaundice is usually harmless and does not influence a baby’s long-term health or growth. It’s a natural, short-lived thing that disappears as the baby’s liver matures. In rare cases, complications can be observed if bilirubin goes too high, but these complications are controlled with regular checks.

Can breast milk jaundice be prevented?

You cannot stop breast milk jaundice itself because breast milk contains natural molecules that temporarily interfere with the breakdown of bilirubin. But by breastfeeding consistently and keeping your baby well-fed, you can prevent other forms of jaundice, including breastfeeding jaundice.

Can formula-fed babies develop jaundice, too?

Yes, formula-fed babies can also develop jaundice, but the causes are different. Formula-fed babies might experience physiological jaundice because of their immature liver or pathological jaundice due to another underlying problem.