Relationship of breast feeding and weight loss to jaundice in the newborn period: review of the literature and results of a study1
A group of 588 consecutively born infants at a community hospital were studied at half-day intervals during their routine hospitalization for jaundice and its relationship to breast milk or formula. Any infant exhibiting a potential risk for jaundice was eliminated from the study. Breast-milk-fed (BMF) infants demonstrated a significantly higher incidence of serum bilirubin (SB) >10 mg/dl and >15 mg/dl (P < .001) than formula-fed (FF) infants. In addition, BMF infants exhibited significantly greater weight loss than FF infants. However, when group effect (BMF or FF) on SB levels was adjusted for weight loss by analysis of covariance testing, differences in SB were less significant, suggesting that weight loss may be a contributory factor to the jaundice seen in BMF infants during the first week of life. A review of the literature is included, and a distinction is proposed between prolonged breast milk jaundice and the early exaggeration of physiologic jaundice in BMF infants.