Breast milk jaundice: causes, treatment, consequences

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Every mother wants the best for her child. And then the long-awaited baby is born. What could be more beneficial and he althier for him than breastfeeding? Unfortunately, on this path, prepared by nature itself, mother often encounters difficulties. One of them is breast milk jaundice. What it is? Is it possible to continue breastfeeding with this diagnosis?

What happens to the newborn?

Statistics inexorably shows that approximately 65% of all newborns acquire a golden, yellow-orange color on the second or third day after birth. From inexperienced mothers, you can hear terrible stories that a child in the hospital was infected with jaundice, blood got into milk, the newborn's liver fails or the bile ducts are clogged. How are things really?

Newborn jaundice, despite the frightening name associated with severe liver disease, is not so terrible. itan indicator of certain processes occurring in the body of a baby who recently changed the mother's womb to diapers and undershirts.

A child's body immediately after birth is forced to rebuild all metabolic processes. At a certain level, his organs and systems may not be able to cope with such a load. Jaundice is one such condition. With it, the level of bilirubin in the blood of the baby rises, and the skin, sclera of the eyes and mucous membranes become yellowish.

Distinguish between physiological and pathological forms. Breast milk jaundice is a transient (physiological) condition of the infant.

Mechanism of jaundice

In human blood there are special blood cells - erythrocytes responsible for the transport of oxygen and carbon dioxide. Their life span is not long and is approximately 120 days. Destroying, they form bilirubin. This is a very toxic substance, so the bloodstream immediately delivers it to the liver, where it is neutralized by liver enzymes and excreted through the bile ducts.

Because of its weakness and immaturity, the baby's liver can not always cope with the amount of incoming bilirubin. Then it enters the bloodstream, causing yellowing of the skin and mucous membranes.

Jaundice develops when the level of bilirubin reaches 50 µmol/liter. The level of total bilirubin above 256 µmol/liter is considered dangerous and requiring immediate therapy.

If the value exceeds 600 µmol/liter, then organic brain damage is possible anddevelopment of cerebral palsy.

Pathological types of jaundice

There are several types of pathological conditions in newborns:

• obstructive jaundice (occurs in the pathology of the biliary systems);
• parenchymal jaundice (manifested in infectious diseases and toxic damage);
• hemolytic jaundice (develops in newborns, in whose blood there is an increased destruction of red blood cells);
• conjugational jaundice (in this type of disease, liver enzymes have low binding capacity).

All these conditions are dangerous and require constant monitoring by doctors.

Physiological state of the baby

Jaundice is not always a pathology. More than half of all babies turn yellow-orange 1-2 days after birth, regardless of the type of feeding. This is due to the immaturity of the liver enzyme system. The condition is not pathological and usually resolves within 1-2 months.

When jaundice of any type occurs, constant monitoring of bilirubin levels is necessary, as high values require immediate treatment. Depending on the growth rate of indicators, the child may be prescribed phototherapy or a blood transfusion. The second type of treatment is usually required for hemolytic jaundice resulting from an Rh conflict between mother and child.

Another physiological type of hyperbilirubinemia is breast milk jaundice, which occurs in breastfed babies. Let's stop atmore details.

Breast milk jaundice in newborns

For quite a long time, hyperbilirubinemia in newborns was considered a pathological condition. However, scientists have noticed that not all yellowed babies have pathologies of the liver, biliary tract, a conflict with their mother in terms of blood group or Rh factor. Then the question arose of whether there could be jaundice from breast milk?

Research in this area shows that this is possible. The phenomenon of breast milk jaundice or Aries syndrome has not yet received a scientific explanation. Some researchers associate it with the ability of mother's milk to slow down processes in the liver. Others suggest that the estrogens contained in women's milk are to blame for everything. It is believed that they displace bilirubin from bonds with glucuronic acid.

In any case, jaundice of breast milk in newborns is not a pathological condition until the values of bilirubin exceed the levels that pose a danger to the life and he alth of the child.

How to distinguish physiological jaundice from Aries syndrome?

Hyperbilirubinemia in breastfed children is almost three times more common than in formula-fed peers. Despite the fact that the true causes of jaundice from breast milk have not yet been identified, recent studies prove that it is completely safe and does not adversely affect the he alth of the newborn.

Bunlike physiological jaundice, which disappears within 20-30 days after birth, Aries syndrome can accompany the baby up to 3-4 months. How to distinguish these two states from each other?

This is easy enough to do: stop breastfeeding for up to 24 hours and check your bilirubin levels before and after the test. With jaundice from mother's milk, its level will decrease by about 20%, with physiological hyperbilirubinemia, it will remain unchanged.

Since both of these conditions do not pose a danger to the newborn with satisfactory bilirubin levels, breastfeeding experts do not advise interrupting feedings. Such an experiment provokes a stressful state of the mother and child and may lead to a decrease in lactation.

Therapy for hyperbilirubinemia

Methods of treating jaundice directly depend on the level of bilirubin in the blood. Because of the possible serious consequences for the child, one should not let things take their course: bilirubin must be controlled. Moreover, the higher its level, the more often it will have to be done.

Interestingly, the underlying cause of hyperbilirubinemia is not too important: both maternal milk jaundice and yellowing caused by hemolytic disease are treated in much the same way. With an increase in the level of bilirubin to 250 µmol / liter, the child is prescribed phototherapy. Radiation converts non-direct, dangerous bilirubin into direct, which is excreted in the urine of a newborn.

Also, the doctor may prescribe supplementation with water or glucose solution: this measureallows you to quickly remove hazardous substances from the body of the baby. If the level of bilirubin rises despite the measures taken, and the cause of hyperbilirubinemia is in breast milk, the mother will be asked to interrupt breastfeeding for up to 24 hours.

At pathological types of jaundice, a decision can be made about a blood transfusion. Such measures are usually taken in severe conditions of the infant and an increase in bilirubin at a rate of 5 µmol/liter per hour.

Should breastfeeding be interrupted?

Due to the lack of information about breast milk jaundice in newborns, a young mother may face a categorically negative attitude of doctors regarding the advisability of breastfeeding. If your baby's blood bilirubin level is less than 250 µmol/litre, you should look for a pediatrician or neonatologist who is knowledgeable about the latest research in this area.

The Breastfeeding Association recommends the following "treatment" for breast milk jaundice:

• If the level of bilirubin is not dangerous, you should not interrupt breastfeeding.
• Breast your baby as often as possible. Mother's milk has a laxative effect: it will help to remove harmful substances much faster.
• The higher the bilirubin level, the calmer and sleepier the child. The more the baby sleeps, the more the concentration of harmful substances in his blood increases. It turns out a vicious circle. To break it, you need to wake the baby and apply to the breast.
• Child undergoing phototherapyneeds a lot of liquid. If there is not enough milk, and the baby cannot be breastfed more often, discuss with your doctor the possibility of feeding with expressed milk or glucose. This option is preferable to a mixture.
• Some lactation consultants recommend boiling breast milk for jaundice as an alternative to formula feeding. During pasteurization, the antibodies and hormones contained in milk are destroyed. How to properly boil? Place a towel folded several times on the bottom of the pan, put bottles of milk and pour water to the level of milk. Bring to a boil and boil for three minutes. Remove bottles and cool. Keep this milk in the refrigerator for no longer than 24 hours.
• If all of the above methods do not help and bilirubin increases, it is worth interrupting breastfeeding for 24-48 hours.

Children at risk

Which babies are most prone to jaundice? At risk are:

• premature or low birth weight babies;
• children from multiple pregnancies;
• babies whose mothers developed gestational diabetes;
• children born with Rh-conflict pregnancy.

What threatens hyperbilirubinemia?

What are the consequences of breast milk jaundice? If the baby's skin casts a golden hue, you can not self-medicate. Bilirubin must be controlled, since its high values can develop into nuclear jaundice, from which one step to cerebral palsy and mentalbackwardness.

At the first signs of hyperbilirubinemia, you should consult a doctor who will draw up an individual visit schedule. If the numbers grow ominously, you may have to stay in the hospital for several days.

Typically, 10 sessions of phototherapy is enough to significantly reduce the level of indirect bilirubin.

Light and modern technologies

Approximately 30 years ago, only exchange transfusion was used to treat neonatal jaundice, until by chance, scientists discovered that when exposed to intense sunlight, dangerous fat-soluble bilirubin becomes water-soluble and is quickly excreted from the body.

It was then that photolamps began to be used to treat hyperbilirubinemia. For the best effect, the baby should have a minimum of clothing - only the genitals and eyes are covered. The baby is in a special box that does not allow him to freeze.

Today there is fiber optic phototherapy technology. At the same time, the baby is wrapped in a special blanket, in which blue lamps are mounted.

The advantage of this method is that you do not have to interrupt the procedure to feed the baby. In addition, the baby, being in the mother's arms, behaves calmer, tolerates phototherapy better.

Home Methods

Is it possible to help a baby with prolonged jaundice if bilirubin values do not exceed dangerous values and special therapy is not indicated? In addition to frequentbreastfeeding, a young mother can be advised to lay the baby out in the sun. However, not under direct sunlight, but under the "lace shade". So the baby will not get sunburn, but he will receive a good dose of ultraviolet radiation, which will help to quickly remove harmful substances from his body.

Various sorbents are often recommended for jaundice: activated carbon, Enterosgel, Creon. Their effectiveness or uselessness has not yet been proven, so be sure to consult your doctor before taking.